[Remote] Care Manager - Registered Nurse at CVS Health

Georgia, Vermont, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Active and unrestricted Registered Nurse (RN) licensure in the state of GA OR compact licensure in state of residence
Proficient in Microsoft Office Suite, including Word, Excel

Responsibilities

Conduct telephonic engagement with members and coordinate their care (50-75% of the day)
Compile all available clinical information and partner with the member to develop an individualized care plan encompassing goals and interventions
Provide evidence-based disease management education and support to help members achieve health goals
Ensure appropriate members of the interdisciplinary care team are involved in the member’s care
Provide care coordination to support a seamless health care experience for the member
Perform meticulous documentation of care management activity in the member’s electronic health record
Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition
Identify and connect members with health plan benefits and community resources
Meet regulatory requirements within specified timelines
Support other members of the Care Team through clinical decision making and guidance as needed
Conduct comprehensive assessments to evaluate members’ needs and address social determinants of health (SDoH) challenges by connecting them with resources
Provide education and guidance to members and families on managing chronic conditions and navigating the healthcare system
Monitor member progress, advocate for necessary services, and collaborate with the interdisciplinary care team for optimal health outcomes
Participate in team meetings to discuss member status and care strategies
Handle additional responsibilities as assigned by leadership, such as special projects, process improvement, or mentoring new team members
Meet performance and productivity metrics, including call volume, successful member engagement, and regulatory requirements

Skills

Key technologies and capabilities for this role

Registered NurseCare CoordinationCase ManagementChronic Disease ManagementTelephonic EngagementCare PlanningSDoH AssessmentPatient EducationInterdisciplinary CollaborationDocumentation

Questions & Answers

Common questions about this position

Is this a remote position or does it require office work?

This information is not specified in the job description.

What are the key responsibilities of the Care Manager RN?

Key responsibilities include 50-75% telephonic engagement with members, developing individualized care plans, providing disease management education, ensuring interdisciplinary team involvement, meticulous documentation, and collaborating to address care barriers.

What is the salary or compensation for this role?

This information is not specified in the job description.

What is the company culture like at CVS Health?

CVS Health emphasizes building a world of health with dedicated, purpose-driven colleagues who are passionate about transforming health care in a connected, convenient, and compassionate way.

What makes a strong candidate for the Care Manager RN position?

Strong candidates should have RN qualifications with expertise in care coordination for complex chronic conditions, experience in comprehensive assessments, individualized care planning, telephonic engagement, interdisciplinary collaboration, and meticulous documentation.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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