Care Manager RN- Field

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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 relate