Remote Case Manager RN II, FL

CVS Health

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Remote
FL – Work from home
Full time
Posted Today
R0186312

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.

 

 

 

This is a full-time remote telework position open to candidates throughout the US located in EST.

 

Hours for this position are 8:00a-5:00p Eastern Standard Time.

 

Position Summary/Mission

Aetna is as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in pursuit of quality solutions that address the full continuum of our members’ health care and social determinant needs.  Dual Eligible Special Needs Plans (DSNP) members are enrolled in Medicare and Medicaid. Our Care Managers are frontline advocates for members who cannot advocate for themselves. Join us in this exciting opportunity as we grow and expand DSNP into new markets across the country.

 

Fundamental Components

  • 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.

 

Required Experience:

  • Minimum 3-5+ years clinical practical experience
  • Minimum 2-3+ years CM, discharge planning and/or home health care coordination experience

 

Preferred Experience:

  • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
  • Bilingual preferred
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills.
  • Ability to work independently
  • Effective computer skills including navigating multiple systems and keyboarding
  • Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications

 

Education and Certification Requirements:

  • Registered Nurse with active state license in good standing within the region where job duties are performed is required.
  • Florida or Compact Licensure required
  • If residing in a compact licensure state, it is preferred that RN license is part of the compact.
  • Certified Case Manager is preferred.

 

 

Pay Range

The typical pay range for this role is:

 

$54,095.60 – $116,800.00

 

This 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 jobs.CVSHealth.com/benefits

 

 

 

We anticipate the application window for this opening will close on: 05/01/2024