Case Manager - Registered Nurse – Field – PA Chester County + Lancaster

CVS Health • Lancaster, PA

81d • $60,522 - $129,615

About The Position

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.

Requirements

• Active and unrestricted Pennsylvania Registered Nurse License.
• Willingness to travel 55-75% within designated areas.
• 3+ years of clinical practical experience in areas such as diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac.
• 2+ years of case management, discharge planning, and/or home health care coordination experience.

Nice To Haves

• Excellent analytical and problem-solving skills.
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently (may require working from home).
• Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint.
• Efficient and effective computer skills including navigating multiple systems and keyboarding.
• Certified Case Manager National professional certification (CRC, CDMS, CRRN, COHN, or CCM).
• Bachelor's Degree in Nursing (PREFERRED).

Responsibilities

• Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
• Develop, implement, and support Health Strategies, tactics, policies, and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.
• Act 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.
• Interact with members/clients telephonically or in person, including home visits.
• Assess and analyze injured, acute, or chronically ill members/clients medical and/or vocational status; develop a plan of care.
• Communicate with member/client and other stakeholders as appropriate.
• Prepare all required documentation of case work activities.
• Interact and consult with internal multidisciplinary team as indicated.
• Provide educational and prevention information for best medical outcomes.
• Conduct an evaluation of members/clients’ needs and benefit plan eligibility.
• Utilize case management processes in compliance with regulatory and company policies and procedures.
• Monitor member/client progress toward desired outcomes through assessment and evaluation.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree