Case Manager Nurse - Field in Charlottesville VA - Registered Nurse or Licensed Practical Nurse at CVS Health

Charlottesville, Virginia, United States

CVS Health Logo
Not SpecifiedCompensation
Mid-level (3 to 4 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

  • Must reside in or near Charlottesville VA
  • Current unrestricted Virginia RN or LPN licensure
  • 3 years clinical experience (preferably in Medical-Surgical Nursing, Behavioral Health, Long Term Care, etc.)
  • 1+ years Managed Care experience
  • Associates degree in Nursing (BSN preferred)
  • Reliable transportation and willingness to travel up to 50-75% of the time (mileage reimbursed)
  • Proficiency with computer skills, including navigating multiple systems and keyboarding
  • Secure, HIPAA-compliant home workspace with reliable phone and hard-wired internet service
  • Proficient in multisystem navigation, using multiple monitors and systems simultaneously
  • Effective multitasker, skilled at talking and typing concurrently
  • Basic technical troubleshooting skills for hardware setup and common issues
  • Experienced in electronic documentation and virtual collaboration tools
  • Highly organized and results-oriented

Responsibilities

  • Evaluating and coordinating care for members to improve overall health and wellness
  • Assessing medical needs and eligibility
  • Developing care plans to address short- and long-term health goals
  • Using clinical tools and data to guide decisions
  • Coordinating services across programs and providers
  • Addressing complex health and social issues
  • Reviewing claims and functional capacity
  • Referring members to appropriate clinical resources
  • Collaborating with supervisors and multidisciplinary teams
  • Ensuring compliance with policies and regulations
  • Engaging members through effective communication
  • Traveling up to 75% to member homes, healthcare facilities, community sites, and other locations
  • Being accessible via phone, videoconference, and email during scheduled hours (Monday-Friday, 8 AM-5 PM EST)

Skills

RN
LPN
Case Management
Care Coordination
Care Planning
Clinical Assessment
Claims Review
HIPAA Compliance
Patient Engagement

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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