CASE MANAGER RN- ILLINOIS
Company: CVS Health
Location: Springfield
Posted on: October 6, 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 Behaviors---
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
SummaryThe Case Manager RN position is 100% remote and employees
can live in any state but most have Illinois RN LicenseNormal
Working Hours: Monday through Friday 9:00am - 5:30pm. There is a
late shift requirement once a quarter 12:30-9:00pmWeekends are not
required.Holidays are covered on a volunteer basis.There is no
travel expected with this position.This Case Manager RN position is
part of Aetna's Commercial Care Management division.The RN's Case
Manager is responsible for telephonically and/or face to face
assessing, planning, implementing, and coordinating all case
management activities with member to evaluate the medical needs of
the member facilitate the member's overall wellness.RN Case Manager
:
- Develop 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 overall wellness through
integration.
- Through the use of clinical tools and information/data review,
conducts an evaluation of member's needs and benefit plan
eligibility and facilitates integrative function as well as smooth
transition to Aetna's programs and plans
- Applies clinical judgement to the incorporation of strategies
designed to reduce risk factors and barriers and address complex
health and social indicators which impact care planning and
resolution of members issues.
- Assessments take into account information from various sources
to address all conditions including co-morbid and multiple
diagnosis that impact functionality.
- Reviews prior claims to address potential impact on current
case management and eligibility.
- Assessments include member's level of work capacity and related
restrictions/limitations.
- Using a holistic approach assess the need for a referral to
clinical resources for assistance in determining
functionality.
- Consults with supervisor and others in overcoming barriers and
meeting goals and objectives, presents cases at case conference for
multidisciplinary focus to benefit overall claim management.
- Utilizes case management processes in compliance with
regulatory and company policies and procedures.
- Utilizes interviewing skills to ensure maximum member
engagement and discern their health status and health needs based
on key questions and conversation.Required Qualifications
- Must have an active current and unrestricted Illinois RN
licensure
- Must be willing to obtain multiple state RN licensure after
hire (expenses paid for by company)
- 2+ years as an RN with med/surge experience Emergency
Department, and Telemetry
- Must be willing to work Monday - Friday 9:00am - 530pm
- Must be willing to work late shift once per quarter until
9pm
- 1+ year experience with all types of Microsoft Office including
Power Point , Excel, and WordPreferred Qualifications
- 2+ years of Case Management experience
- Strong telephonic communication skills
- Certified Case Manager(CCM) certificationEducationAssociates
degree in NursingBSN preferredPay RangeThe typical pay range for
this role is:$66,575.08 - $142,576.72This 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
Health (https://jobs.cvshealth.com/us/en/benefits)We anticipate the
application window for this opening will close on:
10/15/2024Qualified applicants with arrest or conviction records
will be considered for employment in accordance with all federal,
state and local laws.We are an equal opportunity and affirmative
action employer. We do not discriminate in recruiting, hiring,
promotion, or any other personnel action based on race, ethnicity,
color, national origin, sex/gender, sexual orientation, gender
identity or expression, religion, age, disability, protected
veteran status, or any other characteristic protected by applicable
federal, state, or local law.
Keywords: CVS Health, Belleville , CASE MANAGER RN- ILLINOIS, Executive , Springfield, Illinois
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