Full-Time

Case Manager RN

Confirmed live in the last 24 hours

CVS Health

CVS Health

10,001+ employees

Comprehensive pharmacy and healthcare services

Healthcare
Consumer Goods

Compensation Overview

$54.1k - $116.8kAnnually

+ Bonus + Commission + Short-term Incentive Program

Mid, Senior

Company Historically Provides H1B Sponsorship

New Albany, OH, USA

Must live within a commutable distance of New Albany, Ohio (typically within 45 minutes maximum).

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
  • A Registered Nurse that must hold an unrestricted license in their state of residence, preferably with multi-state/compact privileges and be willing and able to be licensed in all non-compact states
  • Upon hire, it will be required to obtain all 50 state licenses
  • 3+ years of clinical practice experience required as an RN
  • There is a requirement to live within a commutable distance of New Albany, Ohio (typically within 45 minutes maximum)
Responsibilities
  • 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
  • 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 consider 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
Desired Qualifications
  • Case Management in an integrated model
  • Certified Case Manager (CCM) certification

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. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals on their journey to better health.

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

1963

Simplify Jobs

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