Field Care Manager, CVS Health

CVS Health

Location:
United States, Raleigh

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

54095.00 - 116760.00 USD / Year

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Job Description:

Community Care Case Manager 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. 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.

Job Responsibility:

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 and in person
Required to meet with members/clients, worksites, acute/post-acute inpatient facilities to provide ongoing case management services
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate
Prepares all required documentation of case work activities as appropriate
Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes
Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work
Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration
Monitors member/client progress toward desired outcomes through assessment and evaluation

Requirements:

Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
Minimum 1 year in CM, discharge planning, hospice, and/or home health care coordination experience or experience working at Wakmed Hospital
Registered Nurse with active state license in good standing within the region where job duties are performed is required
Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership

Nice to have:

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
Bachelor’s degree preferred
Certified Case Manager is preferred
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required

What we offer:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Additional Information:

Job Posted:
September 26, 2025

Expiration:
October 03, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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Field Care Manager