Case Manager RN
Company: CVS Health
Location: Atlanta
Posted on: October 5, 2024
Job Description:
Bring your heart to CVS Health. Every one of us at CVS Health
shares 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.
Anchored in our brand - with heart at its center - our purpose
sends a personal message that how we deliver our services is just
as important as what we deliver.Our Heart At Work BehaviorsTM
support this purpose. We want everyone who works at CVS Health to
feel empowered by the role they play in transforming our culture
and accelerating our ability to innovate and deliver solutions to
make health care more personal, convenient and affordable.Position
SummaryCommunity Care Case Manager use a collaborative process of
assessment, planning, facilitation, care coordination, evaluation,
and advocacy for options and services to meet an individual's and
family's comprehensive health needs through communication and
available resources to promote quality, cost effective outcomes.Job
Duties
- Acts as a liaison with member/client /family, employer,
provider(s), insurance companies, and healthcare personnel as
appropriate.
- Implements and coordinates all case management activities
relating to catastrophic cases and chronically ill members/clients
across the continuum of care that can include consultant referrals,
home care visits, the use of community resources, and alternative
levels of care.
- Interacts with members/clients telephonically or in person. May
be required to meet with members/clients in their homes, worksites,
or physician's office to provide ongoing case management
services.
- Assesses and analyzes injured, acute, or chronically ill
members/clients medical and/or vocational status; develops a plan
of care to facilitate the member/client's appropriate condition
management to optimize wellness and medical outcomes, aid timely
return to work or optimal functioning, and determination of
eligibility for benefits as appropriate.
- Communicates with member/client and other stakeholders as
appropriate (e.g., medical providers, attorneys, employers and
insurance carriers) telephonically or in person.
- Prepares all required documentation of case work activities as
appropriate.
- Interacts and consults with internal multidisciplinary team as
indicated to help member/client maximize best health outcomes.
- May make outreach to treating physician or specialists
concerning course of care and treatment as appropriate.
- Provides educational and prevention information for best
medical outcomes.
- Applies all laws and regulations that apply to the provision of
rehabilitation services; applies all special instructions required
by individual insurance carriers and referral sources.
- Testifies as required to substantiate any relevant case work or
reports.
- Conducts an evaluation of members/clients' needs and benefit
plan eligibility and facilitates integrative functions using
clinical tools and information/data.
- Utilizes case management processes in compliance with
regulatory and company policies and procedures.
- Facilitates appropriate condition management, optimize overall
wellness and medical outcomes, appropriate and timely return to
baseline, and optimal function or return to work.
- Develops a proactive course of action to address issues
presented to enhance the short and long-term outcomes, as well as
opportunities to enhance a member's/client's overall wellness
through integration.
- Monitors member/client progress toward desired outcomes through
assessment and evaluation.Required Qualifications
- Requires an active and good standing Compact RN license
- Minimum 3+ years clinical practical experience preference:
(diabetes, CHF, CKD, post-acute care, hospice, palliative care,
cardiac) with Medicare members preferred.
- Ability to occasionally travel within a designated geographic
area for in-person case management activities as directed by
Leadership and/or as business needs arisePreferred Qualifications
- Minimum 2+ years of case management, discharge planning and/or
home health care coordination experience
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal
skills.
- Ability to work independently (may require working from
home).
- Proficiency with standard corporate software applications,
including MS Word, Excel, Outlook and PowerPoint, as well as some
special proprietary applications.
- Efficient and Effective computer skills including navigating
multiple systems and keyboarding
- Willing and able to obtain multi state RN licenses if
needed
- Certified Case Manager is preferredEducation
- Associate's degree or Nursing Diploma required
- Bachelor's degree preferredPay RangeThe Typical Pay Range For
This Role Is$54,095.60 - $116,760.80This pay range represents the
base hourly rate or base annual full-time salary for all positions
in the job grade within which this position falls. The actual base
salary offer will depend on a variety of factors including
experience, education, geography and other relevant factors. This
position is eligible for a CVS Health bonus, commission or
short-term incentive program in addition to the base pay range
listed above.In addition to your compensation, enjoy the rewards of
an organization that puts our heart into caring for our colleagues
and our communities. The Company offers a full range of medical,
dental, and vision benefits. Eligible employees may enroll in the
Company's 401(k) retirement savings plan, and an Employee Stock
Purchase Plan is also available for eligible employees. The Company
provides a fully-paid term life insurance plan to eligible
employees, and short-term and long term disability benefits. CVS
Health also offers numerous well-being programs, education
assistance, free development courses, a CVS store discount, and
discount programs with participating partners. As for time off,
Company employees enjoy Paid Time Off ("PTO") or vacation pay, as
well as paid holidays throughout the calendar year. Number of paid
holidays, sick time and other time off are provided consistent with
relevant state law and Company policies.For more detailed
information on available benefits, please visit Benefits - CVS
HealthWe anticipate the application window for this opening will
close on: 10/08/2024Qualified applicants with arrest or conviction
records will be considered for employment in accordance with all
federal, state and local laws.
Keywords: CVS Health, Marietta , Case Manager RN, Executive , Atlanta, Georgia
Didn't find what you're looking for? Search again!
Loading more jobs...