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RN Field Case Manager
| Company | CVS Health |
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| Location | Southfield, MI, USA |
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| Salary | $60522 – $129615 |
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| Type | Full-Time |
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| Degrees | Bachelor’s |
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| Experience Level | Mid Level |
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Requirements
- Minimum 3+ years clinical practical experience as an 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.
Responsibilities
- 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.
- 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.
Preferred Qualifications
- 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)
