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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
The CVS Accountable Care RN Care Manager will be the primary care manager for a selected member population. This role is performed face-to-face/field-based and requires those in the position to travel 50-75% of the time outside of the home/office. The RN Care Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members across the continuum of care. The RN Care Manager utilizes advanced clinical judgement and critical thinking skills to effectively manage members through their illness with the goal of assuring the appropriate level of care is being provided, preventing Emergency Department visits and acute admissions, and ensuring the members physical, behavioral, and social needs are being appropriately addressed by the care team to achieve optimal clinical, financial, and quality of life outcomes. Using clinical tools and information/data review, conducts an evaluation of member's needs and applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators to manage the chronic conditions of members. This role is essential for improving patient outcomes and ensuring efficient use of healthcare resources.
Primary responsibilities include but not limited to the following:
- Serve as primary care manager for members identified for Care Management program.
- Engage members to complete a holistic assessments of current health status and work collaboratively with the care team to manage the member’s most difficult symptoms.
- Collaboration with a multi-disciplinary team to develop and implement a care plan that addresses physical, behavioral, and social needs.
- Educate and assist member with advanced care planning.
- Monitor and evaluate effectiveness of the care plan.
- Work with treating physicians to develop anticipatory symptom management plan and monitor for new issues/concerns/changes in pace of illness.
- Prepare member/caregiver to understand and identify signs of functional decline and discuss long term plan for managing to help avert medical emergencies.
- Ensure safe and appropriate transitions of care by collaborating with hospital discharge planners, outpatient provider, family/caregivers, and member, to ensure adequate caregiver assistance, functional support, medical follow up and medication oversight during transition from facility to home.
Required Qualifications
Minimum of 3 years of professional/ clinical nursing experience, with a preference for experience in care coordination
2+ years of telephonic and/ or field care management experience.
A Registered Nurse that must hold an unrestricted compact Virginia license.
Strong organizational, communication, and problem-solving skills; proficiency with electronic health records (EHR) systems
Excellent analytic and problem-solving skills
Willing to travel 50-75% within the Fredericksburg, Virginia area.
Effective computer skills including navigating multiple systems and keyboarding.
Required Attributes
Empathy and Compassion: Essential for patient advocacy and support.
Attention to Detail: Critical for accurate documentation and care planning.
Adaptability: Ability to handle changing situations and patient needs.
Communication Skills: Strong verbal communication skills to effectively interact with patients, families, and healthcare providers over the phone and in person.
Organizational Skills: Excellent organizational and time management skills to handle multiple tasks and prioritize effectively.
Technical Proficiency: Familiarity with electronic medical records (EMR) systems and other healthcare technologies
Interpersonal Skills: Compassionate and empathetic nature, with the ability to provide emotional support to patients.
Preferred Qualifications
Managed Care, care coordination, case management, or a related field
EPIC experience
Medicare experience
Bilingual - English/Spanish
Chronic Disease care management
CCM Certification
Education
Active Registered Nurse (RN) license; a bachelor’s degree in nursing (BSN) is preferred.
Pay Range
The typical pay range for this role is:
$60,522.80 - $129,615.20
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 01/27/2025
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 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
