Case Manager RN (Remote)
Work At Home-Kansas
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.
Case Manager RN
This is a full-time telework position with less than 10% travel required. Hours are M-F, 8:30a-5:00p CST.
Program Overview
Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country.
Position Summary/Mission
Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are 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.
Fundamental Components
• 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 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 …
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Commission CVS Health bonus CVS store discount Dental Development courses Disability benefits Discount Programs Education assistance Employee Stock Purchase Employee stock purchase plan Flexible hours Full range of medical, dental, and vision benefits Full-time Full-time telework Fully-paid term life insurance Holidays Life Insurance Medical Medical, dental, and vision benefits Paid holidays Paid Time Off Short-term incentive program Store discount Telework Term Life Insurance Vacation Vision Vision Benefits Well-being programs
Tasks- Assess member needs
- Collaborate with healthcare teams
- Coordinate case management activities
- Develop care plans
Bilingual English/Spanish Care Coordination Care Planning Case Management Clinical Clinical Judgment Clinical resources Clinical Tools Communication Compliance Data Review Discharge planning Health care Holistic approach Insurance Interviewing Medicaid Medicare Member engagement Motivational interviewing Organization Policies and procedures RN RN licensure
Experience3 years
EducationAssociates Associate's Degree Bachelor Bachelor's Bachelor's degree RN
CertificationsCertified Case Manager RN RN licensure
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9