Case Manager - Field - Northwestern Hospital IL at CVS Health

Schaumburg, Illinois, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care, including consultant referrals, home care visits, use of community resources, and alternative levels of care
Interacts with members/clients telephonically or in person; may meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services
Assesses and analyzes injured, acute, or chronically ill members/clients' medical and/or vocational status; develops a plan of care to facilitate appropriate condition management, optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determine eligibility for benefits as appropriate
Communicates with member/client and other stakeholders (e.g., medical providers, attorneys, employers, insurance carriers) telephonically or in person
Prepares all required documentation of case work activities as appropriate
Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes
Makes outreach to treating physician or specialists concerning course of care and treatment as appropriate
Provides educational and prevention information for best medical outcomes
Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources

Responsibilities

Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes
Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
Develop, implement, and support Health Strategies, tactics, policies, and programs that ensure the delivery of benefits and establish overall member wellness and successful and timely return to work
Work Monday-Friday 8AM-5PM Central with up to 55-75% travel in Chicago; Lake Forest area

Skills

Key technologies and capabilities for this role

Case ManagementPatient CareHealthcare CoordinationAssessmentCare PlanningCommunity CareClinical ModelsWellness ProgramsNetwork Management

Questions & Answers

Common questions about this position

What is the work schedule for this Case Manager position?

The schedule is Monday-Friday from 8AM to 5PM Central.

How much travel is required for this role?

The position requires up to 55-75% travel in the Chicago and Lake Forest area.

What are the main responsibilities of the Case Manager?

The role involves acting as a liaison with members, families, providers, and others; coordinating case management activities for catastrophic and chronically ill cases; interacting with members telephonically or in person; and assessing medical and vocational status.

Is this a remote position, or does it require office presence?

This information is not specified in the job description.

What is the salary or compensation for this position?

This information is not specified in the job description.

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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