Description
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 themselves 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.
Job Summary: In partnership with the primary care provider (PCP), the RN, Case Manager is the lead for care management activities, drives care coordination and collaborates with interdisciplinary teams to ensure care continuity for complex patients.
Core Responsibilities:
- Manages an assigned caseload of complex patients in a value-based care environment, focusing on reducing admissions, readmissions, and medical utilization.
- Accountable for panel metric performance in admission prevention, readmission prevention, and transitions of care metrics.
- Owns overall care coordination for assigned patients, functioning as the primary point of contact and ensuring alignment, accountability, and follow-through across the care team.
- Manage transitions of care episodes for patients, including timely completion of structured clinical assessments and medication reconciliation.
- Collaborates with patient's PCP, family/caregiver, Social Worker, Behavioral Health Specialists, and other care team members to evaluate the individual's needs, goals, and plan of action.
- Ensure timely documentation of key clinical assessments and lead in-person interdisciplinary care planning meetings.
- Perform timely nursing assessments and provide patient education for chronic condition management and transitions of care.
- Educate patients and families, empowering them in their care, and advocating for their needs.
- Document visits in electronic health record according to internal standards.
Requirements:
- Fluency in Spanish or other languages spoken by people in the communities served, strongly preferred.
- Current RN license in assigned state is required; Bachelor degree in nursing preferred.
- Minimum of 6-8 years nursing experience.
- Certified Case Manager (CCM) required, or willingness to obtain within 12 months of hire.
- 2+ years experience in transitional nursing, emergency room nursing, care coordination, discharge planning, or home health is strongly preferred.
- Demonstrated skill in motivational interviewing, patient activation, time management, and navigating community and social resources.
- Access to reliable transportation and ability to travel throughout the communities served.
- US work authorization.
Benefits:
- Mission-focused career impacting change and measurably improving health outcomes for Medicare patients.
- Paid vacation, sick time, and investment/retirement 401K match options.
- Health insurance, vision, and dental benefits.
- Opportunities for leadership development and continuing education stipends.
- New centers and flexible work environments.
Pay Range: $54,095.00 - $116,760.00