Hybrid Case Manager, Registered Nurse – Field

at CVS Health

• Job title: Case Manager, Registered Nurse – Field
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $60,522 - $129,615 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Detroit, United States

About the role

• Field Case Manager role at CVS Health assessing health needs and coordinating care for members in Southeast Michigan. This position involves home visits and collaboration with care teams.

Responsibilities

• Visiting members in their homes to evaluate for appropriateness for waiver services, writing the waiver and submitting for approval.
• 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.

Requirements

• Registered Nurse with active MI state license in good standing
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
• 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
• Care Management, discharge planning and/or home health care coordination experience preferred
• Certified Case Manager preferred
• Associate's Degree required. Bachelor's degree preferred.

Benefits

• 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.
• 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.