[Hiring] Case Manager RN, Compact License @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.

Qualifications

• Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
• Minimum 2+ years CM, discharge planning and/or home health care coordination experience.
• Active and unrestricted Compact License.
• Bilingual preferred - Spanish.
• Certified Case Manager is preferred.
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required.
• Associates Degree or Nursing Diploma Required.
• Bachelors Degree Preferred.

Requirements

• Schedule: Monday-Friday 8AM - 5PM ET.
• Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.
• Interacts with members/clients telephonically or in person.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status.
• Communicates with member/client and other stakeholders as appropriate.
• Prepares all required documentation of case work activities as appropriate.
• Interacts and consults with internal multidisciplinary team as indicated.
• May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
• Provides educational and prevention information for best medical outcomes.
• Applies all laws and regulations that apply to the provision of rehabilitation services.
• Conducts an evaluation of members/clients’ needs and benefit plan eligibility.
• Develops a proactive course of action to address issues presented.
• Monitors member/client progress toward desired outcomes through assessment and evaluation.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.

Company Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.