Remote Case Manager RN - Mandarin - Military Veterans
at CVS Health
CVS Health
To apply for this position please CLICK HERE
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.
Position Summary
This is a full-time telework position.
The hours for this position are Monday-Friday 8:00a-5:00p EST.
Program Overview
Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. 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. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.
Family Summary/Mission
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. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.
Position Summary/Mission
Community Care Case Manager 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 that can include consultant referrals, home care visits, the use of community resources, and alternative levels 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 to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.
* 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; applies all special instructions required by individual insurance carriers and referral sources.
* Testifies as required to substantiate any relevant case work or reports.
* 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.
* Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.
* Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member's/client's overall wellness through integration.
* Monitors member/client progress toward desired outcomes through assessment and evaluation.
Required Qualifications
- Bilingual Chinese Mandarin/English
- 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
- Must possess active and unrestricted Compact RN licensure
- 1+ year(s) of experience with Microsoft Office applications (MS Word, Excel, Outlook and PowerPoint)
Preferred Qualifications
- Minimum 2+ years CM, discharge planning and/or home health care coordination experience
- Certified Case Manager is preferred.
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills.
- Efficient and Effective computer skills including navigating multiple systems and keyboarding
Education
- Associates degree or Nursing Diploma minimum
Pay Range
The typical pay range for this role is:
$54,095.60 - $116,800.00This 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 jobs.CVSHealth.com/benefits
Atlanta, GA
At CVS Health we are transforming health care with a shared purpose: Bringing our heart to every moment of your health™
With 300,000 dedicated colleagues including veterans, service members, Guard and Reserve, and military spouses, we are improving the health of communities across America.
We recognize the value of military service and know that the skills and experience our nation's veterans and military spouses possess are unparalleled. As a CVS Health colleague, you’ll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone’s life, including your own.
As an enduring partner with Military Spouse Employment Partnership for 20 years, we’re committed to providing long-term career potential, opportunity, and support for military spouses.
Corporate Fellowship Programs
Transitioning Service Members - For transitioning service members and Coast Guardsmen within 180 days of separation from service interested in SkillBridge programs, please reach out to YourNextMission@CVSHealth.com to learn about the career tracks that we host participants in.
Accommodation Statement
We provide reasonable accommodations to individuals with disabilities as needed. To request an accommodation – including a qualified interpreter, written information in other formats, translation or other services – please email AdviceandCounsel@cvshealth.com or call 877-805-9511. 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.
EEO Statement
CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT.
Military Spouses - We offer programs throughout the year and have partnered with Hiring Our Heroes to offer a 12-week paid fellowship for military spouses. During this time, you will receive professional training and hands-on experiences across CVS Health enterprise to quickly build your network and showcase your skillset. If you are interested in Military Spouse Fellowship programs, please reach out to our partners at Hiring Our Heroes.