Care Manager - RN at CVS Health

New Albany, Ohio, United States

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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

Key technologies and capabilities for this role

RNCase ManagementTelephonic AssessmentCare PlanningClinical JudgmentRisk AssessmentMember EvaluationWellness CoordinationNetwork Management

Questions & Answers

Common questions about this position

Is this Care Manager RN position remote?

Yes, this position is 100% remote and the employee can live in any state.

What are the normal working hours for this role?

Normal working hours are Monday through Friday 8:00am through 4:30pm in the time zone of residence, with an occasional late shift rotation 10:30am-7pm EST 1-2 times per quarter. Typical training hours are Monday-Friday 8-4:30 EST.

What qualifications are required for the Care Manager RN role?

Candidates must have an active current and unrestricted RN license in the state of residence, with willingness to obtain additional state licenses upon hire (paid by the company), and 5+ years of acute care experience.

What is the salary for this position?

This information is not specified in the job description.

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

A strong candidate will have an active RN license, 5+ years of acute care experience, and the ability to apply clinical judgment in telephonic or face-to-face case management to assess and coordinate member wellness.

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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