Care Manager
Vaya Health
Case Manager, Registered Nurse – Field
CVS Health
full-time
Posted on:
Location Type: Office
Location: Kansas City • Kansas, Montana • 🇺🇸 United States
Visit company websiteSalary
💰 $54,095 - $116,760 per year
Job Level
JuniorMid-Level
About the role
- Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
- Develops, implements, and supports Health Strategies, tactics, policies, and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work
- Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs
- Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
- Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
- Interacts with members/clients telephonically or in person; may be required to meet in homes, worksites, or physician’s office
- Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care
- Communicates with member/client and other stakeholders (medical providers, attorneys, employers and insurance carriers)
- Prepares all required documentation of case work activities
- Interacts and consults with internal multidisciplinary team as indicated
- May make outreach to treating physician or specialists concerning course of care and treatment
- Provides educational and prevention information for best medical outcomes
- Applies all laws and regulations that apply to the provision of rehabilitation services and special instructions required by individual insurance carriers and referral sources
- Testifies as required to substantiate any relevant case work or reports
- Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data
- Utilizes case management processes in compliance with regulatory and company policies and procedures
- Develops a proactive course of action to address issues and enhance short- and long-term outcomes
- Monitors member/client progress toward desired outcomes through assessment and evaluation
Requirements
- Active and unrestricted Kansas Registered Nurse license
- Must live within a 30 mile radius of Kansas University Medical Center. Zip code for KU is 66160
- 3 years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
- 2 years Case Management, discharge planning, and/or home health care coordination experience
- Ability to travel 75% plus, will be reimbursed for mileage and parking
- Associates Degree or Nursing Diploma Required
- Bachelor’s degree preferred
- Certified Case Manager is preferred
- Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required
- 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
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- Eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
- Mileage and parking reimbursement for travel
- Comprehensive and competitive mix of pay and benefits
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
case managementdischarge planninghealthcare coordinationclinical assessmentcare coordinationmedical documentationvocational assessmentwellness promotionbenefit eligibility analysisrehabilitation services compliance
Soft skills
communicationcollaborationadvocacyevaluationproblem-solvinginterpersonal skillsorganizational skillseducational skillsproactive planningteamwork
Certifications
Kansas Registered Nurse licenseCertified Case ManagerCRCCDMSCRRNCOHNCCMAssociates Degree in NursingBachelor’s degreemulti-state RN licenses
