Remote Field Case Manager RN NOVA, Chantilly, Centerville, Herndon, VA

CVS Health

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Job ID: R0100998
Category: Clinical Services
Address: Field
Location: Richmond, VA

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 Summary

Standard business hours Monday-Friday. No nights, no weekends, no holidays and no on call.

 

Work at home with approximately 50-75% of field based travel.

Territory: NOVA Chantilly, Centerville, Herndon and surrounding areas.

 

Required Qualifications
– A Registered Nurse that must hold an unrestricted license in their state of residence, Virginia, with multi-state/compact privileges and have the ability to be licensed in all non-compact states.

– 3+ years clinical experience
– Reliable transportation required
– Mileage is reimbursed per our company expense reimbursement

Preferred Qualifications
– Med surg, ER, home health, long term care, hospice experience
– Case/Care Management in an integrated model preferred
– Bilingual
– Managed Care experience

Education

Associate’s Degree in Nursing

and surrounding areas.

Travel time can be up to an hour (60 miles) each way. Travel will include visiting member home and going into the Chantilly office for meetings.

 

Nurse Case Manager is responsible for telephonically and/or face to face
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 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. Services strategies policies and programs are
comprised of network management and clinical coverage policies.

Through the use of clinical tools and information/data review, conducts an
evaluation of member’s needs and benefit plan eligibility and facilitates
integrative functions as well as smooth transition to Aetna programs and
plans. Applies clinical judgment 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 member issues.
Assessments take into account information from various sources to address
all conditions including co-morbid and multiple diagnoses that impact
functionality. Reviews prior claims to address potential impact on current
case management and eligibility. Assessments include the 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 in meeting goals and objectives, presents cases at
case conferences 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
– A Registered Nurse that must hold an unrestricted license in their state of residence, Virginia, with multi-state/compact privileges and have the ability to be licensed in all non-compact states.

– 3+ years clinical experience
– Reliable transportation required
– Mileage is reimbursed per our company expense reimbursement

Preferred Qualifications
– Med surg, ER, home health, long term care, hospice experience
– Case/Care Management in an integrated model preferred
– Bilingual
– Managed Care experience

Education

Associate’s Degree in Nursing

 

 

Pay Range

The typical pay range for this role is:

 

$67,600.00 – $145,080.00

 

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

 

 

 

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

 

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

 

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.