Case Manager Registered Nurse - Field (Wayne and Macomb Counties) 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

Minimum 3+ years clinical practical experience as a Registered Nurse (RN)
Active and unrestricted Michigan RN licensure
Willing and able to travel up to 25%-50% of the time in Wayne and Macomb Counties; reliable transportation required (mileage reimbursed per company policy)
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint
Effective computer skills including navigating multiple systems
Dedicated workspace free of interruptions for remote work
Dependents must have separate care arrangements during work hours

Responsibilities

Develops 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
Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits
Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
Collaborates with supervisor and other key stakeholders in the member's healthcare in overcoming barriers in meeting goals and objectives; presents cases at interdisciplinary case conferences
Utilizes case management processes in compliance with regulatory and company policies and procedures
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Skills

Key technologies and capabilities for this role

Registered NurseCase ManagementCare PlanningPatient AssessmentHealthcare CoordinationMedicareMedicaidDual EligibleClinical Models

Questions & Answers

Common questions about this position

What is the work arrangement and location for this role?

This is a work-from-home flexible position with 25-50% travel within Southeast Michigan, specifically Wayne and Macomb Counties.

What are the schedule details for this position?

The schedule is standard business hours Monday-Friday from 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 key skills or qualifications are needed for this Case Manager role?

The role requires clinical judgment, experience in case management processes, ability to conduct holistic assessments considering multiple data sources, and collaboration with interdisciplinary teams and stakeholders.

What is the team and mission focus at CVS Health for this position?

Field Case Managers act as frontline advocates for dual eligible members with complex health and social challenges, collaborating with members, providers, and community organizations using compassionate care and best-in-class models.

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

Strong candidates will have nursing expertise to develop proactive care plans, use clinical tools for member evaluations, apply holistic approaches to address complex health and social needs, and excel in interdisciplinary collaboration.

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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