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About the role
- Field Case Manager role at CVS Health assessing health needs and coordinating care for members in Southeast Michigan. This position involves home visits and collaboration with care teams.
Responsibilities
- Visiting members in their homes to evaluate for appropriateness for waiver services, writing the waiver and submitting for approval.
- 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.
Requirements
- Registered Nurse with active MI state license in good standing
- 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
- Effective computer skills including navigating multiple systems and keyboarding
- Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint
- Care Management, discharge planning and/or home health care coordination experience preferred
- Certified Case Manager preferred
- Associate's Degree required. Bachelor's degree preferred.
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- 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 and many other benefits depending on eligibility.
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