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. Successful RNs in this role will live in and hold a compact license. POSITION SUMMARY: The RN Case Manager delivers on the company’s purpose of bringing our heart to every moment of their health through a focus on excellent, purpose-driven customer service. You will engage, navigate, and coordinate initiatives relevant to health care coordination. This position is responsible for assessing, planning, implementing, and coordinating case management activities for patients. In this role, you will:
Be responsible for developing a proactive course of action, reviewing results from data analytics, identifying patient needs, and monitoring their progress throughout a care continuum to enhance the short and long-term health outcomes.
Utilize your superb communication and leadership skills to support our organization to help guide individuals of varying backgrounds towards a common goal for the betterment of a patient’s health and quality of life. In conjunction with care teams across the Enterprise, you will support organizing patient care and educational materials, patient care plans, patient self-management tools, referrals, and procuring community resources.
Track and leverage population disease management practices and commits to recognize and respect cultural diversity for all customers and patients.
Support the management of care for identified members utilizing various tactics including telephone and digital modalities regarding care coordination and under the supervision of a Clinical operations leader. The goal of these care coordination activities will be to make people healthy by influencing and encouraging members to act and drive behavior change. Role entails working with guidance and the expectation that colleagues will adhere to and adopt emerging best practices to satisfy customer needs and exceed expectations.
Manage care for patients enrolled in an Accountable Care Organization (ACO) as well as those part of additional provider partnerships and collaborations, ensuring seamless transitions and continuity of care.
Conduct assessments to identify patients' medical, mental health, and social needs, and develop strategies to address them effectively.
Utilize analytic platforms in a data-driven approach to gather and analyze data related to patient’s needs, progress, and outcomes. Examine patterns and trends in the data to support informed decisions around strategies for each individual patient to improve patient care, ensure timely patient follow-up, and optimize health outcomes as well as analyzing data across the population health which can inform on program development and identify areas for improvement to enhance quality and effectiveness of services.
Educate patients on health-related topics empowering patients to make informed decisions, adopt health lifestyles, and take control of their health and well-being.
Support in implementing initiatives to promote health, deliver preventative care, and enhance overall wellness.
Developing individualized care plans that account for physical, financial, and other constraints.
Reaches out to language line/interpreter when services are needed.
Demonstrates proficiency managing Outlook email and using remote communication software such as Microsoft Teams; able to demonstrate proficiency with Word, Excel, and experience documenting within an electronic health record such as EPIC.
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, company policies and procedures.
Communicates with Retail Health field, clinical team, patients, and families on recommended patient care plans.
Notifies clinical care team of any changes or barriers they encounter as appropriate.
Cross trains to other areas of the retail health management/Gaps in care, as appropriate
Demonstrates respect and regard for the dignity of all patients, members, and fellow colleagues to ensure a professional, responsible, and courteous environment.
Other responsibilities as assigned.
EDUCATION:
Associate degreeREQUIRED SKILLS:
Valid and current Registered Nurse (RN) license in state of employment
Minimum 3 years’ experience as a RN.
PREFERRED EXPERIENCE
Compact RN License
Bachelor’s degree in nursing
Minimum 3 years of health care, customer service, patient relations and/or hospitality concierge experience
Work experience in clinic/health care setting or previous experience with coordination of care
Experience in a clinic/health care setting, call center or telephonic care management setting; previous experience utilizing contact center solutions is advantageous.
Prior experience handling sensitive information confidentially, including information referred to as PHI (patient health information) protected under HIPAA
Experience with electronic medical records, e.g., Epic preferred
Bilingual (Spanish) preferred.
Pay RangeThe typical pay range for this role is:$54,095.60 - $116,800.00This 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 We anticipate the application window for this opening will close on: 06/03/2024We are an equal opportunity and affirmative action employer. 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.
