Case Manager Registered Nurse- Hybrid

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Brief Overview
This is a Hybrid role. The Care Manager RN will be responsible to work from home as well as visit members homes.

The Care Manager RN is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating).  The CM RN utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. 

What you will do

• Responsible for telephonic and/or face to face assessment, planning, implementing and coordinating care management activities with members to ensure that their medical and behavioral health needs are met and to enhance the member’s overall wellness. 

• Develops a proactive course of action to address issues presented and facilitate short and long-term outcomes as well as identify opportunities to enhance a member’s overall health through integration. 

• Through the use of clinical tools and information/data review, conducts comprehensive assessments of member’s needs and recommends an approach to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services.  

• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and addresses complex health and social indicators which impact care planning and resolution of member issues.  

• Completes assessments that take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality and the member’s restrictions and limitations. 

• Analyzes utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.  

• Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated.  

• Provides crisis follow up to members to help ensure they are receiving the appropriate treatment and services. 

• Ap