ACO REACH Telephonic Case Manager RN - Case Management
Company: CVS Health
Location: Chicago
Posted on: September 21, 2023
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Job Description:
ACO REACH Telephonic Case Manager RNJob Description
This is a full-time remote role with a requirement to reside in one
of the following states: Florida, New York, or Illinois.
Working schedule is Monday-Friday; will work between 8am-8pm
CST.
As part of the care coordination team, the ACO REACH RN Case
Manager will be the primary care manager for a selected member
population. The RN Case Manager is responsible for telephonically
assessing, planning, implementing, and coordinating all case
management activities with members across the continuum of care.
The RN Case Manager utilizes advance 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.
Primary responsibilities include but not limited to the
following:
* Serve as primary care manager for members identified for the
Serious Illness program
* Telephonically engage members to complete a holistic assessment
of current health status and work collaboratively with the care
team to manage the member's most difficult symptoms and adaptation
to their ongoing decline
* In collaboration with the multi-disciplinary team, develop and
implement a care plan that addresses physical, behavioral and
social needs
* Educate and assist member with advanced care planning, including
establishing and end-of-life treatment plan
* Monitor and evaluate effectiveness of the care plan and modify
plan in collaboration with multi-disciplinary team as necessary
* 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
* Make referrals to the Pharmacist for medication review and
recommendations as indicated
* Make referrals to Social Worker and/or BH specialist as
indicated
Pay Range
The typical pay range for this role is:
Minimum: 55,300
Maximum: 118,900
Please keep in mind that this range represents the pay range for
all positions in the job grade within which this position falls.
The actual salary offer will take into account a wide range of
factors, including location.
Required Qualifications
* An active and good standing RN in their state of residence
* 3+ years clinical experience required with at least 1 year of
experience in one of the following areas: critical care, ICU, CCU,
Emergency
* 2+ years case management experience required
COVID Requirements
COVID-19 Vaccination Requirement
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.
Preferred Qualifications
* Managed Care experience preferred
* Medicare experience preferred
* Advanced Care Planning Experience preferred
* CCM Certification
* Excellent analytic and problem-solving skills
* Ability to work independently (this position will be work from
home)
* Effective computer skills including navigating multiple systems
and keyboarding
Education
Associate degree minimum
RN with active/current unrestricted state licensure required in the
state candidate resides in.
Business Overview
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.
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.
We strive to promote and sustain a culture of diversity, inclusion
and belonging every day.
CVS Health is an affirmative action employer, and is an equal
opportunity employer, as are the physician-owned businesses for
which CVS Health provides management services. We do not
discriminate in recruiting, hiring, promotion, or any other
personnel action based on race, ethnicity, color, national origin,
sex/gender, sexual orientation, gender identity or expression,
religion, age, disability, protected veteran status, or any other
characteristic protected by applicable federal, state, or local
law.
Keywords: CVS Health, Chicago , ACO REACH Telephonic Case Manager RN - Case Management, Healthcare , Chicago, Illinois
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