Introduction to CVS Health
At CVS Health, we are driven by a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. As a leading healthcare company, we are dedicated to making a positive impact on the lives of our patients, customers, and communities. Our Heart At Work Behaviors support this purpose, empowering everyone who works at CVS Health to feel valued and play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient, and affordable.
Job Summary
We are seeking an experienced and compassionate Case Manager Registered Nurse to join our team in Maricopa County, Arizona. As a Case Manager RN, you will utilize your skills to coordinate, document, and communicate all aspects of the utilization/benefit management program. You will apply critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and medical necessity criteria for members by providing care coordination, support, and education for members through the use of care management tools and resources. This role is work from home with travel required in Maricopa County, Arizona to visit members face to face.
Key Responsibilities
- Conduct comprehensive evaluations of referred member's needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
- Identify high-risk factors and service needs that may impact member outcomes and care planning components with appropriate referrals.
- Coordinate and implement assigned care plan activities and monitor care plan progress.
- Use a holistic approach to overcome barriers to meet goals and objectives; present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
- Identify and escalate quality of care issues through established channels.
- Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
- Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
- Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
- Help members actively and knowledgably participate with their provider in healthcare decision-making.
- Utilize case management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Essential Qualifications
- Must reside in Maricopa County, AZ.
- Active and unrestricted RN license in the state of Arizona.
- Willing and able to travel 50% of their time to meet members face to face within Maricopa County, AZ, and surrounding areas. Reliable transportation required; mileage is reimbursed per our company expense reimbursement policy.
- 2+ years of clinical experience as a RN.
- 2+ years of case management, discharge planning, and/or home healthcare experience.
Preferred Qualifications
- Experience working with people who have been designated as having a serious mental illness (SMI) and experience working with people who are elderly or have a physical disability is very strongly preferred.
- Computer proficient with MS Windows, Outlook, and Word.
- Experience collaborating with medical professionals.
- Strong organization and time management skills.
Education
- Minimum Associate degree in Nursing or Diploma RN required.
- BSN preferred.
Career Growth Opportunities and Learning Benefits
At CVS Health, we are committed to helping our colleagues grow and develop in their careers. As a Case Manager RN, you will have access to a range of training and development programs, including online courses, workshops, and conferences. You will also have the opportunity to work with a talented and experienced team of healthcare professionals who are passionate about delivering high-quality patient care.
Work Environment and Company Culture
Our company culture is built on a foundation of respect, empathy, and inclusivity. We believe in creating a work environment that is supportive, collaborative, and empowering, where everyone feels valued and able to contribute their best. As a remote worker, you will be part of a virtual team that is connected by a shared purpose and values. You will have the flexibility to work from home and travel to meet members face to face, with the support of a dedicated team and the resources you need to succeed.
Compensation, Perks, and Benefits
We offer a competitive salary range of $60,522.80 - $129,615.20 per year, depending on experience and qualifications. In addition to your compensation, you will enjoy a range of benefits, including medical, dental, and vision insurance, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. You will also have access to numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, you will enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.
Conclusion
If you are a compassionate and experienced Registered Nurse who is passionate about delivering high-quality patient care, we encourage you to apply for this exciting opportunity. As a Case Manager RN at CVS Health, you will have the chance to make a real difference in the lives of our members, while also growing and developing your career in a supportive and empowering work environment. Don't miss out on this opportunity to join our team and bring your heart to every moment of our members' health. Apply now and take the first step towards a rewarding and challenging career as a Case Manager RN.
We Encourage You to Apply!
Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team. Apply now and become a part of our dynamic and compassionate team of healthcare professionals.
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