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Experienced Full Time Remote Care Manager Registered Nurse - Field, Utilizing Best-in-Class Operating and Clinical Models to Deliver Enhanced Human-Centric Health Care

100% Remote Full-time Open now

Introduction to CVS Health and Our Mission

At CVS Health, we are driven by 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. As a leader in the health care industry, we are dedicated to making a positive impact on the lives of our members and the communities we serve. Our Heart At Work Behaviors support this purpose, empowering every colleague to play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient, and affordable.

Program Overview and Community Care Team

Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. As a Care Manager Registered Nurse - Field, you will have a life-changing impact on our Community Care members. Community Care is a member-centric, team-delivered, community-based care management model that joins members where they are. 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. This is an exciting opportunity to grow and expand our services to change lives in new markets across the country.

Position Summary and Mission

As a Care Manager Registered Nurse - Field, you will 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. You will communicate and utilize available resources to promote quality, cost-effective outcomes. Your role will involve acting as a liaison with members/clients, families, employers, providers, insurance companies, and healthcare personnel as appropriate. You will implement and coordinate all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.

Key Responsibilities

  • Assess and analyze injured, acute, or chronically ill members/clients' medical and/or vocational status; develop 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.
  • Communicate with members/clients and other stakeholders as appropriate (e.g., medical providers, attorneys, employers, and insurance carriers) telephonically or in person.
  • Prepare all required documentation of case work activities as appropriate.
  • Interact and consult with internal multidisciplinary teams as indicated to help members/clients maximize best health outcomes.
  • May make outreach to treating physicians or specialists concerning the course of care and treatment as appropriate.
  • Provide educational and prevention information for best medical outcomes.
  • Apply all laws and regulations that apply to the provision of rehabilitation services; apply all special instructions required by individual insurance carriers and referral sources.

Essential and Preferred Qualifications

To be successful in this role, you will need to possess a strong and diverse skill set in relevant areas. The essential qualifications for this position include:

  • Active PA, NY, or NJ license
  • Minimum 3+ years of clinical practical experience, with a preference for experience in diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac care with Medicare members.
  • Minimum 2+ years of case management, discharge planning, and/or home health care coordination experience
  • Registered Nurse with an active state license in good standing within the region where job duties are performed
  • Must be willing to travel 0-25%

Preferred qualifications include:

  • Ability to occasionally 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 (may require working from home)
  • 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
  • Willing and able to obtain multi-state RN licenses if needed (company will provide)
  • Bachelor's degree preferred
  • Certified Case Manager is preferred
  • Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required

Education and Skills

An Associate's degree or Nursing Diploma is required, with a Bachelor's degree preferred. You will need to possess strong analytical, problem-solving, and communication skills, as well as the ability to work independently and as part of a team.

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to helping our colleagues grow and develop in their careers. As a Care Manager Registered Nurse - Field, you will have access to a range of training and development opportunities, including free development courses and education assistance. You will also have the opportunity to work with a talented and dedicated team of professionals who are passionate about delivering exceptional patient care.

Work Environment and Company Culture

Our company culture is built on a foundation of respect, empathy, and compassion. We believe in creating a work environment that is inclusive, supportive, and empowering, where every colleague can thrive and reach their full potential. As a Care Manager Registered Nurse - Field, you will be working remotely, with the flexibility to create your own schedule and work environment. You will also have the opportunity to travel occasionally, meeting with members/clients and stakeholders in person.

Compensation, Perks, and Benefits

The typical pay range for this role is $66,575.08 - $142,576.72 per year, depending on experience and location. In addition to your competitive salary, you will also be eligible for a range of benefits, including medical, dental, and vision insurance, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. You will also have access to a range of well-being programs, education assistance, and discount programs with participating partners.

Conclusion

If you are a compassionate and driven Registered Nurse with a passion for delivering exceptional patient care, we encourage you to apply for this exciting opportunity. As a Care Manager Registered Nurse - Field, you will have the chance to make a real difference in the lives of our members, while also growing and developing your career in a supportive and empowering environment. Don't miss out on this opportunity to join our team and help us shape the future of health care. Apply now and let's discuss how you can become a vital part of our success story.

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