Case Manager RN (Wayne and Macomb Counties)

Description

This is a full-time telework role involving up to 25 % - 50% travel in Wayne and Macomb County, MI.

Schedule : Standard business hours - 8 : 00AM-5 : 00PM, no night, weekend or holiday shifts!

There is potential of moving to a four day / ten hour shift schedule after a 6 month probationary period.

Help us elevate our patient care to a whole new level!

Join 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.

Position Summary / Mission Our Care.

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.

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.

• Uses clinical tools and information / data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which

impact care planning.

• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• 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
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications :

• Minimum 3+ years clinical practical experience.
• Must have active and unrestricted RN licensure in the state of MI
• Must be willing and able to travel up to 25%- 50% in Wayne and Macomb County, MI. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications :

• 2+ years of experience in case management, discharge planning and / or home health care coordination experience
• Certified Case Manager
• Additional national professional certification (CRC, CDMS, CRRN, COHN)

Educational Requirements :

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

Pay Range The typical pay range for this role is : $60,522.80 - $129,600.00This 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.