Case Manager Registered Nurse - Work at Home at CVS Health

Texas Twp, Michigan, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Active, current, and unrestricted RN licensure in the state of residence (willing to apply for Compact RN, fees paid by company)
5 years clinical practice experience as an RN
Associate Degree required (BSN preferred)
Ability to work Monday through Friday between 7:00am to 6:00pm CST (subject to change based on business needs)

Responsibilities

Telephonically assess, plan, implement, and coordinate case management activities with members to evaluate medical needs and facilitate overall wellness
Develop proactive course of action to address issues, enhance short- and long-term outcomes, and integrate opportunities for member wellness
Use clinical tools and data review to evaluate member needs, benefit plan eligibility, and facilitate transitions to programs and plans
Apply clinical judgment to incorporate strategies reducing risk factors, barriers, and addressing complex health/social indicators impacting care planning
Conduct assessments considering information from various sources, including co-morbid/multiple diagnoses, prior claims, work capacity, restrictions/limitations, and holistic referral needs
Consult with supervisor/others to overcome barriers, present cases at conferences for multidisciplinary focus
Utilize case management processes in compliance with regulatory and company policies/procedures
Use interviewing skills to maximize member engagement and discern health status/needs

Skills

Case Management

Telephonic Assessment

Care Planning

Clinical Judgment

Risk Assessment

Claims Review

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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