Registered Nurse - RN - Case Management

CVS Health

1d • Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a full-time telework role. Working schedule is Monday-Friday, standard business hours in time zone of residence with one to two days per week until 7 PM. This is an exciting team to join because we specialize in engaging and advocating for disengaged, vulnerable members who often have multiple medical, behavioral, and social challenges. We’re uniquely positioned to meaningfully improve health outcomes and costs. As Case Manager RN, you will be responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and facilitate the member’s overall wellness. You will develop a proactive course of action to address the issues presented to enhance their short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. You will also: Use clinical tools and information/data review to conduct an evaluation of members’ needs and benefits. Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning. Conduct assessments that consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Use a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members. Collaborate with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives. Utilize case management processes in compliance with regulatory and company policies and procedures. Utilize motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Work on behalf of the client and the member's provider.

Requirements

• Registered Nurse that must reside in the Continental United States and hold an unrestricted nursing license with multi-state/compact privileges and have the ability to be licensed in all non-compact states.
• 3+ years clinical/nursing practice experience preferably in ICU or Home Health
• High speed internet- ability to hard wire computer.
• 1+ year(s) of medical case management experience, care coordination or discharge planning.
• 3+ years of experience with personal computers, keyboarding, multi-systems navigation, and MS Office Suite applications

Nice To Haves

• Telephonic case management experience
• Excellent communication and interpersonal skills
• Oncology experience

Responsibilities

• Assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and facilitate the member’s overall wellness.
• Develop a proactive course of action to address the issues presented to enhance their short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
• Use clinical tools and information/data review to conduct an evaluation of members’ needs and benefits.
• Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conduct assessments that consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Use a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborate with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives.
• Utilize case management processes in compliance with regulatory and company policies and procedures.
• Utilize motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
• Work on behalf of the client and the member's provider.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.

What This Job Offers

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