Territory Manager, Surgical
Medtronic
Registered Nurse, Case Manager
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Remote • Illinois • 🇺🇸 United States
Visit company websiteSalary
💰 $66,575 - $142,576 per year
Job Level
Mid-LevelSenior
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 through communication and available resources
- Act 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 and may be required to meet with members/clients in their 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 as appropriate (e.g., medical providers, attorneys, employers and insurance carriers)
- Prepares all required documentation of case work activities as appropriate
- Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes
- Provides educational and prevention information for best medical outcomes
- Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources
- 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 presented to enhance the short and long-term outcomes
- Monitors member/client progress toward desired outcomes through assessment and evaluation
Requirements
- Minimum 3 years clinical practical experience preference required
- Minimum 2 years Case Management, discharge planning and/or home health care coordination experience
- Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
- Ability to travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills
- Ability to work independently
- 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
- Registered Nurse with active state license in good standing in the State of Illinois is required
- Certified Case Manager is preferred
Benefits
- Affordable medical plan options
- a 401(k) plan (including matching company contributions)
- an employee stock purchase plan
- 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
- CVS Health bonus, commission or short-term incentive program (eligible)
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
case managementdischarge planninghealthcare coordinationclinical assessmentcare coordinationbenefit plan eligibility evaluationrehabilitation services complianceanalytical skillsproblem-solving skillsdocumentation preparation
Soft skills
effective communicationorganizational skillsinterpersonal skillsindependent thinkingcollaborationproactive problem-solvingassessment and evaluationmember advocacyteamworkcustomer service
Certifications
Registered NurseCertified Case Manager
