[Hiring] Case Manager RN @CVS Health

Role Description

Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.

• Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
• Develop, implement and support Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.
• Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.
• Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.

Qualifications

• RN Compact license required
• Minimum 5+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
• Minimum 2+ years of discharge planning and/or home health care coordination experience

Requirements

• Minimum 2+ years Case Management Experience
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently (may require working from home)
• Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
• Efficient and Effective computer skills including navigating multiple systems and keyboarding
• Willing and able to obtain multi state RN licenses if needed, company will provide
• Bilingual preferred
• Certified Case Manager is preferred
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required

Benefits

• Comprehensive and competitive mix of pay and benefits
• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources, based on eligibility