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Case Manager Registered Nurse/Licensed Practical Nurse (Field Must reside in King George Virgi[...]
The Muse
King George (VA)
On-site
Full time
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Job summary
A leading healthcare company seeks a Case Manager Registered Nurse or Licensed Practical Nurse for a field-based role in King George, VA. Candidates must have a Virginia state license and experience in clinical settings. The position involves evaluating member needs, coordinating care, and requires significant travel. Great benefits package, competitive salary, and opportunities for advancement are provided.
Benefits
Qualifications
- Must hold a compact RN/LPN/BH license.
- 3 years clinical experience in med surg or behavioral health.
- Bilingual skills preferred.
Responsibilities
- Assess and coordinate member’s care for overall wellness.
- Travel 50-75% of the time to meet with members.
- Conduct evaluations of member needs and facilitate transitions.
Skills
Education
Tools
Job description
1 day ago Be among the first 25 applicants
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.As 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.Position SummaryThis Case Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a field-based position out of King George Virginia or Surrounding Areas . The requirements is for candidates to hold a compact RN/LPN/BH license, and travel 50-75% of the time to meet with members face to face.Nurse Case Manager is 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 course of action to address issues presented to enhance the short and long- term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.Required Qualifications
- LPN/RN/BH with current unrestricted Virginia state licensure required.
- 3 years clinical experience (med surg, behavioral health)
- Proficiency with computer skills which includes navigating multiple systems and keyboarding.
- Must reside in King George VA, or Surrounding areas
- Must possess reliable transportation and be willing and able to travel up to 50-75% of the time. Mileage is reimbursed per our company expense reimbursement policy
- Driver's LicensePreferred Qualifications
- Case Management in an integrated model preferred
- Bilingual preferred
- 5 years clinical practice experience Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
- Effective communication skills, both verbal and written.Education
- Associates Degree Required.
- Bachelor's of Science and Nursing Preferred
- LPN/RN with VA current unrestricted Virginia state licensure Required. Anticipated Weekly Hours
Full timePay Range
The typical pay range for this role is:$22.40 - $129,615.00This 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.Our 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.Great benefits for great peopleWe 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:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- 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.
- Seniority levelMid-Senior level
- Employment typeFull-time
- Job functionHealth Care Provider
- IndustriesTechnology, Information and Internet
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