Case Manager - RN

5 days ago

🌴 South Carolina – Remote

Although this job is listed in South Carolina, this company may be open to hiring remote in other states.

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

Apply Now

Receive Emails with Similar Jobs

CVS Health

WebsiteLinkedInAll Job Openings

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• Nurse Care Manager is responsible for 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. • 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. • Consults with supervisor and others 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.

🎯 Requirements

• Must have active and unrestricted RN licensure in the state of South Carolina OR compact licensure in state of residence • 3+ years of clinical experience • 2+ years of case management, discharge planning and/or home healthcare coordination experience • Certified Case Manager (preferred) • Excellent analytical and problem-solving skills • Bilingual (preferred) • Effective communications, organizational, and interpersonal skills • Ability to work independently • Effective computer skills including navigating multiple systems and keyboarding • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.

🏖️ Benefits

• Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs • Confidential counseling and financial coaching • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.