Health Coach Consultant (Arizona Candidates Only)

CVS Health•Work At Home-Arizona, AZ

2d•$60,522 - $129,615•Remote

About The Position

This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients. The schedule is Monday through Thursday from 8:30 AM to 8:00 PM EST, and Friday from 8:30 AM to 5:00 PM EST. Candidates must reside in Arizona and will work in either Mountain Time (MT) or Arizona Time (AZ). Employees will work an 8-hour shift within these hours, aligned to their local time zone. This is a work-at-home position, and all training will be conducted virtually. The role involves enhancing medical appropriateness and quality of care through the application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, policies, procedures and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits. It also involves applying clinical judgment to strategies designed to reduce risk factors and barriers and address complex health and social indicators that impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Utilizing motivational interviewing skills is key for maximum member engagement and discerning health status and needs. The role requires identifying and escalating member's needs appropriately following set guidelines and protocols, and actively reaching out to members to collaborate/guide their care.

Requirements

3+ years’ experience as a Registered Nurse.
The AHH RN Case Manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support.
1+ years Nursing Management experience in patients with Diabetes, Cardiac Disease, ICU, CCU, Home Health or Pulmonary Disease.
1+ years documenting electronically using keyboard and multiple computer screens--free form text/good typing skills and Microsoft Office applications especially Excel required.
Must have active and unrestricted RN licensure in the state you reside.
Compact Licensure RN License is required for this role.
Candidates must reside in Arizona.
Must have hard wired internet.

Nice To Haves

1+ years current or previous experience in Home Health.
1+ years Case Management experience preferred.
1+ years experience with Lexicomp a plus.
1+ years experience Motivational Interviewing a plus.
Certified Diabetes Care and Education Specialist (CDCES).
Bilingual in Spanish preferred.
Bachelor’s preferred.

Responsibilities

Enhancement of Medical Appropriateness and Quality of Care
Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, policies, procedures and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits.
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Identifies and escalates member's needs appropriately following set guidelines and protocols.
Actively reach out to members to collaborate/guide their care.