About the role

Case Manager Registered Nurse providing healthcare coordination for dual eligible populations and addressing complex health and social challenges. Join CVS Health to elevate patient care and improve member wellness.

Responsibilities

Help elevate patient care through delivery of appropriate benefits and/ or healthcare information determining eligibility for benefits while promoting wellness activities.
Develops, implements, and supports Health Strategies, tactics, policies, and programs for delivery of benefits and overall member wellness.
Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
Implement and coordinate all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.
Assess and analyze injured, acute, or chronically ill members/clients medical and/or vocational status; develop a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes.
Communicate with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
Monitor member/client progress toward desired outcomes through assessment and evaluation.

Active and unrestricted Registered Nurse License in Illinois
Minimum 3-5 years clinical practical experience preference required
Minimum 2-3 years CM, discharge planning and/or home health care coordination 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
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
Must possess reliable transportation and be willing and able to travel up to 75% of the time

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
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