Case Manager - Registered Nurse - Field - Southwest Michigan + Bonus Available

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.\n\nAs 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.\n\nOur Mission\n\nOur Field Case Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.\n\nPosition Summary\n\nJoin our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. 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 dually eligible members to change lives in new markets across the country.\n\nHelp us elevate our patient care to a whole new level!\n\nKey Responsibilities\n

• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.\n
• Uses clinical tools and information / data review to conduct an evaluation of member's needs and benefits.\n
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.\n
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.\n
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.\n
• Collaborates with supervisor and other key stakeholders in the member's healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.\n
• Utilizes case management processes in compliance with regulatory and company policies and procedures.\n
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.\n\nRemote Work Expectations\n
• This a remote role with 25-50% travel required, candidates must have a dedicated workspace free of interruptions.\n
• Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.\n
• This role is eligible for a new hire bonus.\n\nRequired Qualifications\n
• 3+ years clinical practical experience as an Registered Nurse (RN)\n
• Candidate must have active and unrestricted Michigan Registered Nurse (RN) licensure\n
• Candidate must be willing and able to travel up to 25%- 50% of the time in Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties (Reliable transportation required - Mileage is reimbursed per our company expense reimbursement policy)\n
• Ability to work independently\n
• Effective computer skills including navigating multiple systems and keyboarding\n
• Demonstrates proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook, and PowerPoint\n\nPreferred Qualifications\n
• 2+ years of experience in case management, discharge planning and / or home health care coordination experience\n
• Behavioral health experience\n
• Bilingual in Spanish or Arabic\n
• Certified Case Manager\n
• Additional national professional certification (CRC, CDMS, CRRN, COHN)\n
• Excellent analytical and problem-solving skills\n
• Effective communications, organizational, and interpersonal skills\n\nEducational\n
• Associate's Degree in Nursing (REQUIRED)\n
• Bachelor's Degree in Nursing (PREFERRED)\n\nAnticipated Weekly Hours\n40\n\nTime Type\nFull time\n\nPay Range\n\nThe typical pay range for this role is : \n\n$60,522.00 - $129,615.00\n\nThis 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.\n\nOur people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.\n\nGreat benefits for great people\n\nWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include : \n
• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.\n
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.\n
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.\n\nFor more information, visit https : / / jobs.cvshealth.com / us / en / benefits\n\nWe anticipate the application window for this opening will close on : 10 / 31 / 2025\n\nQualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.