Hybrid Case Manager, Registered Nurse

Posted 2 hours ago

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About the role

  • Care Manager Registered Nurse supporting dual eligible populations at CVS Health. Collaborating with members, providers, and community organizations for comprehensive health care and social support.

Responsibilities

  • 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

  • Must possess reliable transportation and be willing and able to travel up to 25% of the time in and around candidates home location.
  • Minimum 3-5 years clinical practical experience required
  • 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
  • Minimum 2-3 years Care Management, discharge planning and/or home health care coordination experience preferred
  • Certified Case Manager

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
  • Many other benefits depending on eligibility

Job title

Case Manager, Registered Nurse

Job type

Experience level

Mid levelSenior

Salary

$66,575 - $142,576 per year

Degree requirement

Associate's Degree

Location requirements

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