Case Manager RN - Field (Northside of Chicago)
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Position Summary
Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs.
Position Summary/Mission
Our Case Managers 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 to promote quality, cost-effective outcomes.
Fundamental Components & Physical Requirements
- 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 with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services.
- Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management.
- Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers, and insurance carriers) telephonically or in person.
- 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.
- May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
- Provides educational and prevention information for best medical outcomes.
- Applies all laws and regulations that apply to the provision of rehabilitation services.
- Conducts an evaluation of members/clients’ needs and benefit plan eligibility.
- Utilizes case management processes in compliance with regulatory and company policies and procedures.
- Monitors member/client progress toward desired outcomes through assessment and evaluation.
Required Qualifications
- Active and unrestricted RN in IL.
- Minimum 3+ years clinical practical experience required.
- Minimum 2+ years CM, discharge planning and/or home health care coordination experience.
- Ability to travel 50-75% within the Northside of Chicago.
Preferred Qualifications
- Excellent analytical and problem-solving skills.
- Effective communications, organizational, and interpersonal skills.
- Ability to work independently.
- Proficiency with standard corporate software applications.
- Confidence working at home/independent thinker.
- Certified Case Manager is preferred.
Education
- Associates degree or Nursing Diploma is required.
- Bachelors degree is preferred.
Pay Range
The typical pay range for this role is: $66,575.08 - $142,576.72.
We anticipate the application window for this opening will close on: 11/29/2024.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health requires certain colleagues to be fully vaccinated against COVID-19, where allowable under the law.
About us
Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference.
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