Care Manager RN- Field

CVS Health
Illinois, IL Full Time
POSTED ON 1/13/2024 CLOSED ON 2/2/2024

What are the responsibilities and job description for the Care Manager RN- Field position at CVS Health?

Qualifying candidates may be eligible for a sign on bonus of up to $7,000.

This is a telework role open to candidates in Livingston, Ford, McLean, and DeWitt Counties. This role will require 75% travel in the assigned region.

Working schedule: Monday-Friday, 8am-5pm.

Position Summary
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 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 to change lives in new markets across the country.

Family Summary/Mission
Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops,
implements, and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.

Position Summary/Mission
Our Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.

Fundamental Components & Physical Requirements
  • Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
  • Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
  • Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services.
  • Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.
  • Communicates with member/client and other stakeholders as appropriate (e.g., medical
providers, attorneys, employers and insurance carriers)telephonically or in person.
  • Prepares all required documentation of case work activities as appropriate.
  • Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
  • May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
  • Provides educational and prevention information for best medical outcomes.
  • Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.
  • Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
  • Utilizes case management processes in compliance with regulatory and company policies and procedures.
  • Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to
work.
  • 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/client’s overall wellness through integration.
  • Monitors member/client progress toward desired outcomes through assessment and evaluation.

Pay Range
The typical pay range for this role is:
Minimum: 58,760
Maximum: 125,840

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


Required Qualifications

Minimum 3 years clinical practical experience
Must have active and unrestricted RN licensure in the state of IL
Willing and able to travel 75% travel within Livingston, Ford, McLean, and DeWitt Counties. Reliable transportation required. Mileage reimbursed per our company expense reimbursement policy

COVID Requirements

COVID-19 Vaccination Requirement
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.

Preferred Qualifications
  • Minimum 2 years CM, discharge planning and/or home health care coordination experience
  • Certified Case Manager is preferred
  • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
  • Ability to travel within a designated geographic area for in-person case management activities as directed by leadership and/or as business needs arise
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills
  • Ability to work independently
  • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
  • Efficient and Effective computer skills including navigating multiple systems and keyboarding

Education
Associate Degree, BSN Preferred

Business Overview
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
RN - Intensive Care Unit
Providence RN -
Seaside, OR
RN Charge - Respiratory Cardiac Care
Providence RN -
Portland, OR
RN Wound Care - TEMP DAYS
RN Staff -
Utah County, UT

For Employer
Looking for Real-time Job Posting Salary Data?
Keep a pulse on the job market with advanced job matching technology.
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

Sign up to receive alerts about other jobs with skills like those required for the Care Manager RN- Field.

Click the checkbox next to the jobs that you are interested in.

  • Case Management Skill

    • Income Estimation: $84,376 - $110,118
    • Income Estimation: $90,677 - $112,636
  • Diagnosis and Treatment Planning Skill

    • Income Estimation: $85,045 - $107,773
    • Income Estimation: $85,878 - $138,785
This job has expired.
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Not the job you're looking for? Here are some other Care Manager RN- Field jobs in the Illinois, IL area that may be a better fit.

RN- Registered Nurse Care Manager- Join our Team

Firstat RN Care Management Services, Beach, FL

Team RN: Train, Care, Develop; Superb Work/Life Balance

On it RN - RN Services, Vancouver, WA