Case Manager Registered Nurse - Michigan (Remote) 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 MI state license in good standing
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work (implied full-time in standard business hours, fully remote with dedicated workspace free of interruptions; dependents must have separate care arrangements during work hours)

Responsibilities

Develops a proactive plan of care to address identified issues to enhance the 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 CoordinationAssessmentPlanningImplementationMedicareMedicaidDual EligibleHealthcareCommunication

Questions & Answers

Common questions about this position

Is this Case Manager position remote?

Yes, the position is fully remote, allowing work from home in Michigan.

What is the work schedule for this role?

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

What are the key responsibilities of the Case Manager?

Key responsibilities include developing proactive plans of care, conducting evaluations of member needs using clinical tools, applying clinical judgment to reduce risk factors, performing holistic assessments, and collaborating with supervisors and interdisciplinary teams.

What qualifications are needed for this Registered Nurse Case Manager role?

The role requires being a Registered Nurse with skills in clinical judgment, case management activities like assessing, planning, implementing, and coordinating care, and experience working with dual eligible populations facing complex health and social challenges.

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

CVS Health emphasizes a compassionate, connected, and convenient approach to health care with dedicated, purpose-driven colleagues passionate about transforming health care and advocating for members who cannot advocate for themselves.

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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