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Job Details


CVS Health

Field Case Manager RN - Madison County IL (2009588BR)

Pharmaceuticals

All

Yearly

No

Granite City, Illinois, United States

Job Description
Qualifying candidates may be eligible for up to a $7,000 sign on bonus.

Candidate will be responsible for an assigned geographical area based on where they reside within the counties of Beecher, IL. Chicago Heights, IL. Palos Heights, IL. Crestwood, IL., Willow Springs, IL. Cook County, Will County.

Program Overview
Help us elevate our patient care to a whole new level! 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 duallyeligible members to
change lives in new markets across the country.
Position Summary/Mission
Our Care 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.
Fundamental Components
• 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.

Required Qualifications
• Minimum 3 or more years clinical practical experience.
• Minimum 2 or more years case management, discharge planning and/or home health care coordination experience.
• Registered Nurse with active compact state license in good standing in IL is required.
• Must be willing to travel 50 - 75% in Madison County IL

COVID Requirements


COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
• Bachelor’s degree preferred.
• Certified Case Manager is preferred.
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently (may require working from home).
• Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
• Efficient and Effective computer skills including navigating multiple systems and keyboarding
• Willing and able to obtain multi state RN licenses if needed, company will provide.

Education
Associates degree required; Bachelors degree preferred

Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.