Registered Nurse, Case Manager Job at CVS Health (Work at Home)

Job 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.

Job Responsibility

Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness
Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits
Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
Collaborates with supervisor and other key stakeholders in the member's healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation
Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician's office to provide ongoing case management services. Travel can be up to 40% of the work week

Requirements

Must reside in the state of Illinois
Must possess reliable transportation and be willing and able to travel up to 40% of the time from home location. Mileage is reimbursed per our company expense reimbursement policy
Minimum 3-5 years clinical practical experience
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently
Effective computer skills including navigating multiple systems and keyboarding
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
Associate's degree required, along with active and unencumbered Registered Nurse license in the state of Illinois

Nice to have

2-3 years Care Management, discharge planning and/or home health care coordination experience
Certified Case Manager
Bilingual

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Mileage reimbursement

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Registered Nurse, Case Manager

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