Case Manager, Registered Nurse (Remote) at CVS Health

Missouri City, Missouri, United States

Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Active and unrestricted Registered Nurse (RN) licensure in the state of Ohio or compact licensure in state of residence
Proficient in Microsoft Office Suite, including Word and Excel
Ability to meet performance and productivity metrics
Conduct oneself with integrity, professionalism, and self-direction
Experience or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care
Familiarity with community resources and services
Ability to navigate and utilize various healthcare technology tools
Maintain strong collaborative and professional relationships with members and colleagues
Communicate effectively, both verbally and in writing
Excellent customer service and engagement skills

Responsibilities

Conduct comprehensive assessments to evaluate members' needs
Address social determinants of health (SDoH) challenges by connecting members with appropriate resources and support services
Provide education and guidance to members and their families on managing chronic conditions and navigating the healthcare system
Develop and implement individualized care plans
Monitor member progress and advocate for necessary services
Collaborate with the interdisciplinary care team to ensure optimal health outcomes
Accurately and timely document assessments and interventions
Participate in team meetings to discuss member status and care strategies
Provide telephonic engagement with members and coordinate their care (50-75% of the day)
Identify and connect members with health plan benefits and community resources
Meet regulatory requirements within specified timelines
Support other members of the Care Team through clinical decision making and guidance as needed
Participate in special projects, contribute to process improvement initiatives, or assist with mentoring new team members as assigned by leadership

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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