NC – Work from home
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 telework role within the US and the potential candidates should have considerable clinical experience in Maternity nursing; antepartum through postpartum. Labor and Delivery experience is required.
Work schedule: Monday-Friday, standard business hours, including 2 evening shifts per week from 12:30-9:00 PM EST. Rotating Friday evening approximately once per month.
Goal of program is healthy moms and healthy babies. The Case Manager (CM) utilizes a collaborative process of assessment, planning, implementation, and evaluation, to engage, educate, and promote and influence member’s decisions related to achieving and maintaining optimal health status. The Case Manager (CM) will complete an initial risk assessment for the member. The Case Manager (CM) must be very knowledgeable with pregnancy risk, both initial risk and then throughout pregnancy. They must listen for potential risk, helping to early identify any potential issues. If needed Case Manager (CM) will call the provider to discuss risk.
– Assessing members through the use of clinical tools and information/data review, conducts comprehensive evaluation of member’s needs and benefit plan eligibility for available integrated internal and external programs/services.
-Utilizes assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.
Enhancement of Medical Appropriateness & Quality of Care:
-Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits and/or member’s needs to enable appropriate utilization of services and/or administration and integration with available internal/external programs.
-Using holistic approach consults with supervisors, Medical Directors and/or others to overcome barriers to meeting goals and objectives.
-Identifies and escalates quality of care issues through established channels.
-Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
-Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
-Interprets and utilizes clinical guidelines/criteria to positively impact members health Provides up-to-date healthcare information to help facilitate the member¡¦s understanding of his/her health status.
-Helps member actively and knowledgably participate with their provider in healthcare decision-making.
-Monitoring, Evaluation and Documentation of Care
– Develops and monitors established plans of care, in collaboration with the member and/or attending physician, to meet the member’s goals.
– Utilizes internal policy and procedure in compliance with regulatory and accreditation guidelines.
For more information on our benefit programs, please visit
-Active and unrestricted RN licensure in the state of residence with ability to apply for and obtain additional licenses required per account needs
– 5 years of clinical experience in Maternity Nursing: antepartum, labor and delivery, recovery, postpartum, as well as lactation education
-5 years experience educating expectant mothers through each trimester of pregnancy: fetal development, health comorbidities/diagnoses that may impact pregnancy and fetal development, expectations of changes to body during pregnancy, healthy nutrition, and weight gain, troubleshooting side effects and when to escalate concerns to their provider, lab testing and understanding results, signs of labor, postpartum recovery, and lactation expectations, just to name a few.
– Must be able to conduct telephonic work from home in a secure environment while utilizing own high-speed internet. Must be able to be hardwired to the internet source.
-Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties. Some candidates may be eligible for partial reimbursement of the cost of residential broadband service
– Experience with Microsoft Word, Outlook, Excel, and comfortable using various computer programs
– Be able to work independently as well as part of a team to accomplish team goals and business expectations
-Demonstrate ability to communicate, problem solve, and work effectively with people, using good judgment in challenging situations
– Unrestricted Compact RN Licensure with ability to apply for and obtain additional licenses required per account needs
– Previous coaching experience
– Managed care experience
– Experienced with the Epic electronic health records data base.
– Background in motivational interviewing
Associate Degree required; Bachelor’s degree preferred
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.
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