# Case Manager

**Company**: CVS Health
**Location**: Monroeville, PA
**Work arrangement**: onsite
**Experience**: senior
**Job type**: full-time
**Salary**: $60,522.00 - $129,615.00
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/PA---Monroeville/Case-Manager--Registered-Nurse---Field---Forbes-Hospital--PA_R1070932?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_3a63e9c6-9ac

## Description

We’re building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

Join the Aetna Clinical Collaboration (ACC) team, an innovative and growing, community-based care management model designed to transform how we serve our members.

As a Case Manager, you will apply a collaborative, member-centered approach to assessment, care planning, coordination, evaluation, and advocacy to address the comprehensive health needs of individuals and families.

**Responsibilities:**

- Serve as a liaison between members, families, employers, providers, insurance carriers, and healthcare personnel.

- Implement and coordinate case management activities for catastrophic and chronically ill members across the continuum of care.

- Interact with members both telephonically and in person while working on-site at Forbes Hospital.

- Assess medical, functional, and vocational status to develop and implement individualized plans of care.

- Communicate effectively with stakeholders, including medical providers, attorneys, employers, and insurance carriers.

- Prepare timely and accurate documentation of all case management activities.

- Collaborate with internal multidisciplinary teams to support optimal member outcomes.

- Conduct outreach to treating physicians and specialists to support appropriate care planning.

- Provide education and preventive guidance to promote best clinical outcomes.

- Apply applicable laws, regulations, and payer requirements related to rehabilitation and case management services.

- Monitor member progress toward desired outcomes and adjust care plans as needed.

- Develop proactive strategies to address complex needs and support both short- and long-term wellness outcomes.

**Requirements:**

- Reliable transportation and the ability to consistently meet on-site, hospital-based work requirements at Forbes Hospital, PA up to 50-75%.

- Active and unrestricted Registered Nurse (RN) License in Pennsylvania.

- 3+ years of clinical experience, preferably with Medicare and Commercial populations.

- Ability to work independently within a hospital-based environment.

- Strong analytical, problem-solving, organizational, and communication skills.

- Proficiency in MS Word, Excel, Outlook, PowerPoint, and proprietary clinical systems.

- Efficient computer skills, including navigating multiple systems and keyboarding.

**Preferred Qualifications:**

- 3+ years of experience in care management, discharge planning, or home health coordination.

- Willingness to obtain multi-state RN licensure (company supported).

- National certification (CRC, CDMS, CRRN, COHN, or CCM).

**Benefits:**

- Medical, dental, and vision coverage.

- Paid time off.

- Retirement savings options.

- Wellness programs.

**Salary Range:** $60,522.00 - $129,615.00

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## Skills

### Required
- Registered Nurse (RN)
- Clinical Experience
- Case Management
- Microsoft Office
- Analytical Skills
- Communication Skills

### Nice to have
- Care Management
- Discharge Planning
- Home Health Coordination
- Multi-state RN Licensure
- National Certification

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/PA---Monroeville/Case-Manager--Registered-Nurse---Field---Forbes-Hospital--PA_R1070932?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)