This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
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. The Case Manager RN utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. The Case Manager RN process includes assessing the member's health status and care coordination needs, inpatient review, and discharge planning, developing, and implementing the case management plan, monitoring, and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria.
Job Responsibility:
Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs
Conduct comprehensive clinical assessments
Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services
Advocate for patients to the full extent of existing health care coverage
Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency
Identify and escalate quality of care issues through established channels
Provide an expected very high level of customer service
Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change
Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
Provide coaching, information, education, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
Requirements:
Must have an active current and unrestricted RN license in state of residence
Willingness and ability to obtain additional state licenses upon hire (paid for by the company)
3+ years of acute care experience as an RN required, Med Surg or Critical Care preferred
Must be willing to work, Monday through Friday 9:00am through 5:30pm in time zone of residence with an occasional late shift rotation per the needs of the business 11:30am-8pm EST
Associate Degree in Nursing required
Nice to have:
Compact RN License or Multi state licensure
Certified Case Manager (CCM)
Telephonic case management and/or telephonic experience
BSN preferred
What we offer:
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching