Case Manager Registered Nurse – Field – Must reside in Petersburg Virginia or Surrounding Areas at CVS Health

Petersburg, Virginia, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Must reside in Petersburg, VA or surrounding areas
Must possess reliable transportation and be willing and able to travel up to 50-75% of the time (mileage reimbursed per company policy)
RN with current unrestricted Virginia state licensure required
3 years clinical experience (preferably in Medical-Surgical Nursing, Behavioral Health, Long term Care, etc.)
Proficiency with computer skills, including navigating multiple systems and keyboarding
Associate's Degree in Nursing required (Bachelor's Degree in Science & Nursing preferred)

Responsibilities

Assessing, planning, implementing, and coordinating all case management activities with members to evaluate medical needs and facilitate overall wellness
Developing a proactive course of action to address issues, enhance short- and long-term outcomes, and integrate services, strategies, policies, and programs
Using clinical tools and information/data review to evaluate member's needs, benefit plan eligibility, and facilitate transitions to Aetna programs and plans
Applying clinical judgment to incorporate strategies that reduce risk factors and barriers, addressing complex health and social indicators impacting care planning
Conducting assessments considering information from various sources, including co-morbid and multiple diagnoses, prior claims, work capacity, restrictions/limitations, and holistic needs for referrals
Consulting with supervisor and others to overcome barriers, presenting cases at case conferences for multidisciplinary focus
Utilizing case management processes in compliance with regulatory and company policies and procedures
Utilizing interviewing skills to ensure maximum member engagement and discern health status and needs

Skills

Key technologies and capabilities for this role

RNCase ManagementLong-Term Services & SupportClinical AssessmentCare PlanningPatient CoordinationVirginia RN License

Questions & Answers

Common questions about this position

Is this a remote position or does it require fieldwork?

This is a Field Based role out of Petersburg, Virginia or surrounding areas, involving typical office working environment with periods of sitting, talking, and listening.

What license is required for this Case Manager RN position?

Candidates must hold a current unrestricted Virginia state RN licensure.

Where must candidates reside to apply for this role?

Candidates must reside in Petersburg, Virginia or surrounding areas.

What are the main responsibilities of the Nurse Case Manager?

The role involves assessing, planning, implementing, and coordinating case management activities, evaluating medical needs, developing proactive courses of action, and using clinical judgment to reduce risk factors and address health and social indicators.

What is the employment type for this position?

This is a full-time position.

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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