Case Manager RN - Field (Southwest Michigan)

CVS Health • Kalamazoo, MI

1d • Remote

About The Position

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. Position Summary Location: This role will be work at home with 25-50% travel within Southwest Michigan (Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties). Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST, no night, weekends, or holiday shifts! There is potential of moving to a four day / ten hour shift schedule after a 6 month probationary period. Our Mission Our Field Case Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. 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. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in new markets across the country. Help us elevate our patient care to a whole new level!

Requirements

• Minimum 3+ years clinical practical experience as an Registered Nurse (RN).
• Must have active and unrestricted Michigan RN licensure.
• Must be willing and able to travel up to 25%- 50% of the time in Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties.
• Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy.
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint
• Effective computer skills including navigating multiple systems and keyboarding
• 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

Nice To Haves

• 2+ years of experience in case management, discharge planning and/or home health care coordination experience.
• Behavioral health experience.
• Bilingual in Spanish or Arabic.
• Certified Case Manager.
• Additional national professional certification (CRC, CDMS, CRRN, COHN).

Responsibilities

• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.
• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborates 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.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
• For more information, visit https://jobs.cvshealth.com/us/en/benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree