Case Manager RN

Job DescriptionThe in-person, onsite position of Nurse Advocate is onsite at Children's Healthcare of Atlanta Support Center at 1575 Northeast Expressway, Atlanta, GA 30329. This is not a work-from-home position.The hours are Monday through Friday for 8 hours between the hours of 8:00am - 6:00pm EST per the needs of Children's Healthcare of Atlanta.There are no weekend or holiday hours expected.There are no additional evening hours past 6:00pm EST expected at this time, however, some flexibility will be needed to attend meetings outside of typical business hours.There is no travel expected with this position.The dedicated and onsite Nurse Advocate position for Children's Healthcare of Atlanta will engage, educate, promote, and influence members to enable decisions related to achieving and maintaining optimal health status. They will work with both members and the HR Benefits /Wellness teams on ways to deliver the best member experience and optimize the benefits offered through the employee benefits plan. The Onsite Nurse Advocate will:-Present clinical and benefit strategy recommendations to Children's Healthcare of Atlanta based on the analysis of the Children's Healthcare of Atlanta specific utilization.-This analysis should include an overview of additional clinical management opportunities as well as an assessment of the effectiveness of the management programs currently in place, trends, new products, and service offerings to Children's Healthcare of Atlanta.-Daily Roster and pop health reporting -Focus efforts around wellness-Work with members to help understand their benefits and connect them to the appropriate resources available to them through a collaborative process of assessment, planning, facilitation, advocacy, and communication. -Assist members in identifying modifiable risk factors and referring and leveraging the coaching resources provided by employer to coach on lifestyle change, including weight management, quitting tobacco, stress reduction, nutrition and increasing physical activity. -Assess, coach and referral of members with chronic health conditions to an Aetna In Touch Care Premier Nurse. Develop and implement goals with members to maintain optimum level of health.-Establish a plan of care based on member's health status, and educational and support needs -Identify co-morbid conditions, hospitalizations, prescriptions, and other factors that could impact the coaching and support needs of the member outside the scope of the health coaching -Facilitate group coaching and health education sessions-Support clinical integration and collaboration on member's care plan in conjunction with multiple health professionals -Refer members to appropriate resources and/or programs when indicated-Work with onsite health clinic to coordinate wellness activities as appropriate-Work with health plan clinical or customer service resources to coordinate benefits and available resources/programs-Work with the Children's HR Benefits team, Aetna account management team and clinical program consultant to identify trends and gaps in the employee benefits plan through their interactions with employees.-The Nurse Advocate will be a conduit between clinical team, account team and Children's-The Nurse Advocate will work with account to identify opportunities to include additional support needs, programs, service, and educational opportunitiesIn addition to providing face-to-face coaching, the Onsite Health Advocate seeks to engage employees at the designated location through: -Group coaching sessions-Telephone and email follow ups-Health education seminars using Aetna materials-Health awareness tables-Team meetings, meet-and-greet sessions-Health education newsletters-Other onsite events coordinated by the employer group-Very high level of customer serviceRequired Qualifications-Must have an active and unrestricted RN license-Willingness and ability to obtain additional state licenses upon hire (paid for by the company)-3+ years of recent acute hospital clinical experience as an RN (general medical, post-surgical, ICU experience). Recent defined as in the past 10 years.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications-BSN-1+ years of case management experience-Certified Case Manager (CCM) certification -Experience with all types of Microsoft Office including PowerPoint, Excel, and Word-Strong telephonic communication skillsEducation-Associates Degree in NursingBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-15