Case Manager Nurse - Field in Harrisonburg Virginia - Registered Nurse or Licensed Practical Nurse at CVS Health

Harrisonburg, Virginia, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Reside in or near Harrisonburg, VA
Reliable transportation and willingness to travel up to 50-75% of the time (mileage reimbursed)
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
Proficiency with computer skills, including navigating multiple systems and keyboarding
Associates degree in Nursing (BSN preferred)
Secure, HIPAA-compliant home workspace with reliable phone and hard-wired internet service
Technology skills: Proficient in multisystem navigation, using multiple monitors/systems simultaneously, effective multitasking (talking and typing concurrently), basic technical troubleshooting, digital collaboration & documentation, highly organized & results-oriented
Case Management in an integrated model preferred (Waiver and IDDP)
Bilingual in English/Spanish preferred

Responsibilities

Evaluate and coordinate care for members to improve overall health and wellness
Assess medical needs and eligibility
Develop care plans to address short- and long-term health goals
Use clinical tools and data to guide decisions
Coordinate services across programs and providers
Address complex health and social issues
Review claims and functional capacity
Refer members to appropriate clinical resources
Collaborate with supervisors and multidisciplinary teams
Ensure compliance with policies and regulations
Engage members through effective communication
Travel to member homes, healthcare facilities (e.g., nursing homes, rehab centers), community sites, and client/company locations (up to 75% field travel)
Be accessible via phone, videoconference, and email during scheduled hours (Monday-Friday, 8 AM-5 PM EST)

Skills

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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