Case Manager Registered Nurse - Field (Cook County) at CVS Health

Chicago, Illinois, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Registered Nurse (RN) license (implied by job title and clinical responsibilities)
Ability to travel up to 50% throughout the South Suburbs of Chicago in Cook County (WFH/Field position)
Skills in assessment, planning, facilitation, care coordination, evaluation, and advocacy
Ability to interact telephonically or in person, including home visits, worksites, or physician’s offices
Knowledge of laws and regulations related to rehabilitation services, insurance carriers, and referral sources
Ability to conduct evaluations of members’/clients’ needs and benefit plans

Responsibilities

Act as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel
Implement and coordinate case management activities for catastrophic cases and chronically ill members/clients across the continuum of care, including consultant referrals, home care visits, community resources, and alternative levels of care
Interact with members/clients telephonically or in person, including meetings in homes, worksites, or physician’s offices
Assess and analyze injured, acute, or chronically ill members’/clients’ medical and/or vocational status; develop a plan of care to optimize wellness, medical outcomes, timely return to work or optimal functioning, and determine eligibility for benefits
Communicate with member/client and stakeholders (e.g., medical providers, attorneys, employers, insurance carriers) telephonically or in person
Prepare all required documentation of case work activities
Interact and consult with internal multidisciplinary team to maximize best health outcomes
Make outreach to treating physicians or specialists concerning course of care and treatment
Provide educational and prevention information for best medical outcomes
Apply all laws, regulations, special instructions from insurance carriers and referral sources

Skills

Key technologies and capabilities for this role

Registered NurseCase ManagementCare CoordinationPatient AssessmentHealth Care PlanningClinical ModelsMedicareMedicaidSocial Determinants of Health

Questions & Answers

Common questions about this position

What is the work arrangement for this Case Manager position?

The role is WFH/Field with up to 50% travel throughout the South Suburbs of Chicago in Cook County. Interactions with members may occur telephonically, in person, or at homes, worksites, or physician’s offices.

What salary or compensation is offered for this role?

This information is not specified in the job description.

What are the key responsibilities of a Case Manager in this position?

Case Managers act as a liaison with members, families, providers, and others; implement and coordinate case management for catastrophic and chronic cases across the continuum of care; and assess medical/vocational status to develop care plans.

What is the company culture like at CVS Health for this role?

CVS Health emphasizes building a world of health with dedicated, purpose-driven colleagues passionate about transforming health care in a connected, convenient, and compassionate way, focusing on collaborative care for complex populations.

What makes a strong candidate for this Case Manager Registered Nurse role?

Strong candidates will have Registered Nurse qualifications with skills in assessment, planning, care coordination, and advocacy for complex health needs, plus experience liaising with providers and families in field-based settings.

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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