Care Manager - RN at CVS Health

New Albany, Ohio, United States

Apply Now

Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Active current and unrestricted RN license in state of residence, with willingness and ability to obtain additional state licenses upon hire (paid for by the company)
5+ years of acute care experience as an RN
Willing and able to work Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation (10:30am-7pm EST, 1-2 times per quarter)
Strong computer skills with Microsoft Suite familiarity
Associate's degree with RN licensure (BSN preferred)

Responsibilities

Telephonically and/or face-to-face assess, plan, implement, and coordinate all case management activities with members to evaluate medical needs and facilitate overall wellness
Develop a proactive course of action to address issues, enhance short- and long-term outcomes, and integrate services, strategies, policies, and programs
Use clinical tools and information/data review to evaluate member's needs, benefit plan eligibility, and facilitate transitions to programs and plans
Apply clinical judgment to incorporate strategies reducing risk factors and barriers, addressing complex health and social indicators impacting care planning and resolution
Conduct assessments considering information from various sources, including co-morbid and multiple diagnoses impacting functionality, prior claims, work capacity, and restrictions/limitations
Use a holistic approach to assess need for referral to clinical resources for functionality determination
Consult with supervisor and others to overcome barriers, present cases at case conferences for multidisciplinary focus
Utilize case management processes in compliance with regulatory and company policies and procedures
Utilize motivational interviewing (MI) skills to ensure maximum member engagement and discern health status

Skills

Case Management

Telephonic Assessment

Care Planning

Clinical Judgment

Risk Assessment

Member Evaluation

Wellness Coordination

Network Management

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.

Land your dream remote job 3x faster with AI

Try Jobo Free