Case Manager RN

About the role

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Schedule

Normal Working Hours: Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation per the needs of the business 11:00 AM-8:00 PM EST (once per Quarter). No travel is expected with this position. Anticipated Weekly Hours: 40. Time Type: Full time.

Responsibilities

• Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and escalate quality of care issues through established channels.
• Provide an expected very high level of customer service.
• Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information, education, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

Requirements

• Must have an active current and unrestricted RN license in state of residence.
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company).
• 3+ years of acute care experience as an RN required.
• Ass