Case Manager RN- Field

Job DescriptionQualifying candidates may be eligible for up to a $5,000 sign on bonus.Help us elevate our patient care to a whole new level This role will be 40-50% travel within Wayne and Macomb Counties once covid restrictions are lifted.Schedule: Standard business hours - 8:00AM-5:00PM, no night, weekend orholiday shifts Join our Aetna team as an industry leader in serving dual eligible populations byutilizing best-in-class operating and clinical models. You can have life-changingimpact on our members who are enrolled in Medicare and Medicaid and presentwith a wide range of complex health and social challenges. With compassionateattention 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 aswe grow and expand dually eligible members to change lives in new marketsacross the country. Position Summary/Mission Our Care Managers are frontlineadvocates for members who cannot advocate for themselves. They areresponsible for assessing, planning, implementing, and coordinating all casemanagement activities with members to evaluate the medical needs of themember to facilitate the member's overall wellness. Develops a proactive plan of care to address identified issues to enhance theshort and long-term outcomes as well as opportunities to enhance a member'soverall wellness. Uses clinical tools and information/data review to conduct an evaluation ofmember's needs and benefits. Applies clinical judgment to incorporate strategies designed to reduce riskfactors and barriers and address complex health and social indicators whichimpact care planning. Conducts assessments that consider information from various sources, suchas claims, to address all conditions including co-morbid and multiple diagnosesthat impact functionality. Uses a holistic approach to assess the need for a referral to clinical resourcesand other interdisciplinary team members. Collaborates with supervisor and other key stakeholders in the member'shealthcare in overcoming barriers in meeting goals and objectives, presentscases at interdisciplinary case conferences Utilizes case management processes in compliance with regulatory andcompany policies and procedures. Utilizes motivational interviewing skills to ensure maximum memberengagement and discern their health status and health needs based on keyquestions and conversation.Required Qualifications Minimum 3 or more years clinical practical experience. Minimum 2 or more years case management, discharge planning and/or home health care coordination experience. Registered Nurse with active compact state license in good standing in MI is required. Must be willing to travel 25-50% in Wayne and Macomb counties in MICOVID 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 Bachelor's degree preferred. Certified Case Manager is preferred. Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required Excellent analytical and problem-solving skills Effective communications, organizational, and interpersonal skills. Ability to work independently (may require working from home). Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. Efficient and Effective computer skills including navigating multiple systems and keyboarding Willing and able to obtain multi state RN licenses if needed, company will provideEducationAssociates degree required;BSN preferredBusiness 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: 2025-10-04