CVS Health Nurse Case Manager - RN in Blue Bell, Pennsylvania
This position will be working from home anywhere in the United States and will require occasional late night, weekend and holiday work.
Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health care needs through communication and available resources to promote optimal, cost-effective outcomes. The CM process includes: assessing the member's health status and care coordination needs, inpatient review and discharge planning, developing and implementing the case management plan, ongoing evaluation of the case plan with Medical Director as indicated, exceptional disease education skills and case closure when closure criteria achieved.
3+ years of Med/Surg experience.
Requires a Compact RN License
- Case Management Certification (CCM) preferred, but not required.
Additional Job Information
Occasional late shift, weekend, holiday coverage. Requires multistate licensure. We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company.
Bachelor's degree or equivalent experience
Percent of Travel Required
0 - 10%
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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