Quality Management Nurse Consultant

Posted:
12/18/2024, 5:32:35 AM

Location(s):
Illinois, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Consulting ⋅ Medical, Clinical & Veterinary

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.

This position is Virtual.

There is a preference for nurses in a compact RN licensure state, however, that is not required. Active and unrestricted RN licensure in IL or OH is a requirement.

Normal Working Hours: Monday through Friday between the hours of 8:00am – 5:00pm for a scheduled 8-hour shift.

Position Summary

Fundamental Components/Expectations
• Serve as an incident reporting expert for Aetna Care Management.
• Lead and demonstrate the How We Work Behaviors (specifically collaboration, team building between all members of the care team)
• Accountable for detailed knowledge of regulatory or state specific requirements for incident reporting
• Mentor the care team regarding best practice standards, quality of interventions, problem resolution and critical thinking and standard operating practices.
• Provides ongoing education to staff regarding opportunities and processes, critical thinking and problem solving to resolve critical incidents
• Will review and have a solid understanding of Policies and Procedures, desktops and job aids and support these
• Support a positive work environment that promotes the concept of teamwork
• Perform detailed review on case manager identified critical incident to ensure they meet state, national and corporate requirements.


Required Qualifications

  • Must possess active and unrestricted RN licensure in state of residence. Will be expected to obtain and maintain multi-state or state specific licensure.
  • Active and unrestricted RN licensure in IL or OH is required.
  • 3+ year(s) of experience Care Management
  • 2+ year(s) of experience with documenting in an EMR
  • 3+ year(s) experience with Microsoft Excel, Outlook, PowerPoint and Teams
  • Minimum 1+ year(s) of experience with informal mentoring of staff


Preferred Qualifications

  • Compact RN License  
  • Dynamo experience

Education

  • Associate of Applied Science in Nursing Required
  • BSN Preferred

Pay Range

The typical pay range for this role is:

$66,575.08 - $142,576.72

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: 01/01/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.