Full-Time

Case Manager RN

Field

Posted on 12/6/2024

CVS Health

CVS Health

10,001+ employees

Comprehensive pharmacy and healthcare services

Healthcare
Consumer Goods

Compensation Overview

$72.6k - $155.5kAnnually

+ Bonus + Commission + Short-term Incentive Program

Mid, Senior

Company Historically Provides H1B Sponsorship

Jackson Township, NJ, USA

Work from home with 25-50% travel around Ocean County, NJ. Must reside close to or within Ocean County.

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary

You match the following CVS Health's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • Minimum 3+ years of clinical practice experience
  • Must have active and unrestricted RN licensure in the state of NJ
  • Willing and able to travel 25-50% of their time using your own vehicle to meet members face to face in their assigned area. Reliable transportation required.
  • Must reside close to or within Ocean County, New Jersey
Responsibilities
  • Assessing, planning, implementing, and coordinating all case management activities with members
  • Using clinical tools and information/data review to conduct an evaluation of member's needs and benefits
  • Applying clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
  • Conducting assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
  • Using a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
  • Collaborating with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
  • Utilizing case management processes in compliance with regulatory and company policies and procedures
  • Utilizing motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Desired Qualifications
  • Certified Case Manager is preferred
  • Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred
  • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills
  • Ability to work independently
  • Effective computer skills including navigating multiple systems and keyboarding
  • Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
  • Bilingual Preferred

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. The company serves individual consumers, businesses, and communities, offering prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also functions as a pharmacy benefits manager, managing health plans for over 75 million members, and provides specialized care for seniors and patients requiring specialty pharmacy services. This integrated approach allows CVS Health to deliver affordable health management solutions, improve access to quality care, and enhance health outcomes while aiming to reduce overall healthcare costs. The company's goal is to support individuals in achieving better health through its comprehensive services.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

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Simplify's Take

What believers are saying

  • Expansion of telehealth services allows CVS to reach more patients remotely.
  • Increased consumer interest in wellness boosts demand for CVS's health-related products.
  • The trend towards value-based care aligns with CVS's integrated healthcare approach.

What critics are saying

  • Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.
  • The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.
  • The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

What makes CVS Health unique

  • CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.
  • The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.
  • CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

INACTIVE