Case Manager Registered Nurse - Field (Southwest Michigan) at CVS Health

Michigan City, Mississippi, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Registered Nurse with active license
Ability to work from home with 25-50% travel within Southwest Michigan (Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties)
Dedicated workspace free of interruptions
Dependents must have separate care arrangements during work hours

Responsibilities

Visiting members in their homes to evaluate for appropriateness for waiver services, writing the waiver and submitting for approval
Developing a proactive plan of care to address identified issues to enhance short and long-term outcomes as well as opportunities to enhance a member’s overall wellness
Using clinical tools and information/data review to conduct an evaluation of member's needs and benefits
Applying clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
Conducting assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
Using a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
Collaborating with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presenting cases at interdisciplinary case conferences
Utilizing case management processes in compliance with regulatory and company policies and procedures
Utilizing motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation
Assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness

Skills

Key technologies and capabilities for this role

Registered NurseCase ManagementCare CoordinationAssessmentPlanningMedicareMedicaidDual EligibleHealthcareCommunication

Questions & Answers

Common questions about this position

Is this position remote or does it require travel?

This role is work at home with 25-50% travel within Southwest Michigan, covering counties like Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien.

What is the work schedule for this Case Manager role?

The schedule is standard business hours Monday-Friday 8:00am-5:00pm EST, with no nights, weekends, or holidays, and potential to move to a four-day/ten-hour shift after a 6-month probationary period.

What are the key responsibilities of this Field Case Manager position?

Responsibilities include visiting members in their homes to evaluate for waiver services, developing proactive care plans, using clinical tools for needs evaluation, applying clinical judgment to reduce risks, and conducting assessments from various sources.

What is the salary or compensation for this role?

This information is not specified in the job description.

What kind of experience makes a strong candidate for this Case Manager RN position?

Strong candidates will have registered nurse experience with skills in clinical assessment, care planning, case management for complex populations like dual eligible Medicare/Medicaid members, and the ability to travel for home visits.

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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