Case Manager RN - Field - Case Management
Company: CVS Health
Location: Skokie
Posted on: April 16, 2024
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Job Description:
Case Manager RN - Field
Bring your heart to CVS Health. Every one of us at CVS Health
shares a single, clear purpose: Bringing our heart to every moment
of your health. This purpose guides our commitment to deliver
enhanced human-centric health care for a rapidly changing world.
Anchored in our brand - with heart at its center - our purpose
sends a personal message that how we deliver our services is just
as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone
who works at CVS Health to feel empowered by the role they play in
transforming our culture and accelerating our ability to innovate
and deliver solutions to make health care more personal, convenient
and affordable.
Position Summary
This is a remote position that requires 50-75% travel in Cook
County/Chicago, IL and surrounding areas to meet with members face
to face. (Must have reliable transportation).
Schedule is Monday-Friday, standard business hours, 8:00am-5:00pm
CST.
Nurse Case Manager is responsible for telephonically and/or face to
face assessing, planning, implementing and coordinating all case
management activities with LTSS members to evaluate the medical
needs of the member to facilitate the member's overall
wellness.
- Develops a proactive course of action to address issues presented
to enhance the short and long-term outcomes as well as
opportunities to enhance a member's overall wellness through
integration. Services strategies policies and programs are
comprised of network management and clinical coverage policies.
- Through the use of clinical tools and information/data review,
conducts an evaluation of member's needs and benefit plan
eligibility and facilitates integrative functions as well as smooth
transition to Aetna programs and plans.
- 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.
- Reviews prior claims to address potential impact on current case
management and eligibility.
- Assessments include the member's level of work capacity and
related restrictions/limitations.
- Using a holistic approach assess the need for a referral to
clinical resources for assistance in determining functionality.
- Consults with supervisor and others in overcoming barriers in
meeting goals and objectives, presents cases at case conferences
for multidisciplinary focus to benefit overall claim
management.
- Utilizes case management processes in compliance with regulatory
and company policies and procedures.
- Utilizes interviewing skills to ensure maximum member engagement
and discern their health status and health needs based on key
questions and conversation.
Required Qualifications
* Minimum of 2 years of experience in behavioral health or social
services field.
* Minimum 2 years of clinical experience
* Current active and unrestricted RN licensure in the state of
IL
* Willing and able to travel 50-75% of their time to meet members
face to face within Cook County/Chicago, IL and surrounding
areas.
* Reliable transportation required; Mileage is reimbursed per our
company expense reimbursement policy
Preferred Qualifications
* Case management and discharge planning experience
* Managed Care experience
* Microsoft Office experience
Education
* Associate's degree with RN licensure required
* BSN preferred
Pay Range
The typical pay range for this role is:
This pay range represents the base hourly rate or base annual
full-time salary for all positions in the job grade within which
this position falls. The actual base salary offer will depend on a
variety of factors including experience, education, geography and
other relevant factors.
In addition to your compensation, enjoy the rewards of an
organization that puts our heart into caring for our colleagues and
our communities. The Company offers a full range of medical,
dental, and vision benefits. Eligible employees may enroll in the
Company's 401(k) retirement savings plan, and an Employee Stock
Purchase Plan is also available for eligible employees. The Company
provides a fully-paid term life insurance plan to eligible
employees, and short-term and long term disability benefits. CVS
Health also offers numerous well-being programs, education
assistance, free development courses, a CVS store discount, and
discount programs with participating partners. As for time off,
Company employees enjoy Paid Time Off ("PTO") or vacation pay, as
well as paid holidays throughout the calendar year. Number of paid
holidays, sick time and other time off are provided consistent with
relevant state law and Company policies.
For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits
This job does not have an application deadline, as CVS Health
accepts applications on an ongoing basis.
CVS Health requires certain colleagues to be fully vaccinated
against COVID-19 (including any booster shots if required), where
allowable under the law, unless they are approved for a reasonable
accommodation based on disability, medical condition, religious
belief, or other legally recognized reasons that prevents them from
being vaccinated.
You are required to have received at least one COVID-19 shot prior
to your first day of employment and to provide proof of your
vaccination status or apply for a reasonable accommodation within
the first 10 days of your employment. Please note that in some
states and roles, you may be required to provide proof of full
vaccination or an approved reasonable accommodation before you can
begin to actively work.
CVS Health is committed to recruiting, hiring, developing,
advancing, and retaining individuals with disabilities. As such, we
strive to provide equal access to the benefits and privileges of
employment, including the provision of a reasonable accommodation
to perform essential job functions. CVS Health can provide a
request for a reasonable accommodation, including a qualified
interpreter, written information in other formats, translation or
other services through If you have a speech or hearing disability,
please call 7-1-1 to utilize Telecommunications Relay Services
(TRS). We will make every effort to respond to your request within
48 business hours and do everything we can to work towards a
solution.
Keywords: CVS Health, Evanston , Case Manager RN - Field - Case Management, Executive , Skokie, Illinois
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