RN Field Case Manager-Southwest Michigan

CVS Pharmacy; Southfield (MI); Hybrid; USD 60,000 - 130,000; Full time

Job summary

An established industry player in health solutions is seeking a dedicated RN to elevate patient care through comprehensive case management. This role offers a unique opportunity to make a life-changing impact on dual eligible populations, addressing their complex health and social challenges. With a focus on collaboration and compassionate care, you will develop proactive care plans and utilize clinical tools to enhance member outcomes. Enjoy a flexible work-from-home environment with travel opportunities, and benefit from a supportive team committed to transforming health care. Join us in making a difference in the lives of our members.

Benefits

Medical Insurance

401(k) Plan

Employee Stock Purchase Plan

Wellness Programs

Paid Time Off

Flexible Schedules

Tuition Assistance

Qualifications

• 3+ years of clinical practical experience as an RN.
• Active and unrestricted Michigan RN licensure.

Responsibilities

• Assess, plan, implement, and coordinate case management activities.
• Develop proactive care plans to enhance outcomes and wellness.
• Collaborate with stakeholders and present cases at conferences.

Skills

Clinical Judgment

Motivational Interviewing

Case Management

Communication Skills

Education

Associate's Degree

Bachelor's Degree

Job description

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 Summary

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

This role will be work at home with 25-50% travel within Southwest Michigan (Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties).

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.

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 a life-changing impact on our members enrolled in Medicare and Medicaid, who 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 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 Responsibilities

• Assess, plan, implement, and coordinate all case management activities with members to evaluate medical needs and facilitate overall wellness.
• Develop proactive care plans to address issues, enhance outcomes, and promote overall wellness.
• Use clinical tools and data review to evaluate member needs and benefits.
• Apply clinical judgment to reduce risk factors and address complex health and social indicators impacting care planning.
• Conduct assessments considering information from various sources, including claims, to address all conditions affecting functionality.
• Use a holistic approach to assess the need for referrals to clinical resources and interdisciplinary team members.
• Collaborate with supervisors and key stakeholders, present cases at interdisciplinary conferences.
• Utilize case management processes in compliance with regulations and policies.
• Employ motivational interviewing skills to maximize member engagement and discern health needs.

Required Qualifications

• Minimum 3+ years of clinical practical experience as an RN.
• Active and unrestricted Michigan RN licensure.
• Willingness and ability to travel up to 25-50% within specified counties. Reliable transportation required; mileage reimbursed.

Preferred Qualifications

• 2+ years of experience in case management, discharge planning, or home health care coordination.
• Behavioral health experience.
• Bilingual in Spanish or Arabic.
• Certified Case Manager or other relevant national certifications (CRC, CDMS, CRRN, COHN).

Educational Requirements

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

Additional Details

Anticipated weekly hours: 40

Time type: Full time

Pay range: $60,522.00 - $129,615.00, depending on experience, education, and location.

Our comprehensive benefits include medical, 401(k), employee stock purchase plan, wellness programs, paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, and more. For details, visit https://jobs.cvshealth.com/us/en/benefits.

Application deadline: 05/09/2025. CVS Health is an equal opportunity employer and complies with all applicable laws regarding employment discrimination.