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 is a full-time telework position with up to 10% travel required.

Hours for this position are Monday-Friday 8:00a-5:00p CST.

A Brief Overview
Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.

What you will do

• Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings.

• Analyzes complex patient data from medical history, diagnostic test results, and treatment plans, to understand the current health status of the patient.

• Applies in-depth knowledge of case management and nursing practices to organize patient files in an orderly manner for easy retrieval.

• Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans.

• Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care.

• Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient progress and manages specific conditions.

• Coordinates analytics projects to enable case managers to analyze data and generate reports on key performance health indicators.

• Designs complex processes to coordinate discharge planning in a safe and timely transition from the hospital to home.

• Develops resource management to help case managers optimize healthcare with community resources.

Required Qualifications

• Must have active and unrestricted RN licensure in the state of IL

• 3+ years of clinical work experience

• 1+ year(s) of Case Management experience

• Must be willing and able to travel up to 10% of the time. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications

• Case Management experience in the insurance industry

• Compact RN licensure

• Certified Case Manager

• Telephonic Nursing experience

• Home Health experience

• Additional national professional certification (CRC, CDMS, CRRN, COHN) is preferred, but not required

Education

• Associate's Degree required, Bachelor’s degree preferred

Pay Range

The typical pay range for this role is:

$60,522.80 - $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: 01/24/2025

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