Hybrid Clinical Case Manager – Registered Nurse

at CVS Health

• Job title: Clinical Case Manager – Registered Nurse
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $66,575 - $142,576 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, United States

About the role

• Clinical Case Manager at CVS Health coordinating member physical and behavioral healthcare. Utilizing clinical judgment, assessing needs, and promoting optimal health outcomes.

Responsibilities

• Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning
• Conducts comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution
• Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services
• Consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives
• Identifies and escalates quality of care issues through established channels
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/ behavior changes to achieve optimum level of health
• Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.
• Develops and monitors established plans of care to meet the member’s goals.

Requirements

• Active and unrestricted Illinois Registered Nurse (RN) License
• 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
• Proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.

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.
• 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.