Join Our Team: Transforming Healthcare with CVS Health
At CVS Health, we're dedicated to bringing our heart to every moment of your health. As a leading healthcare company, we're committed to delivering enhanced, human-centric care in a rapidly changing world. Our purpose is at the center of everything we do, guiding our commitment to making healthcare more personal, convenient, and affordable.
About Aetna One Advocacy (A1A)
Aetna One Advocacy (A1A) is Aetna's premier service and clinical offering, providing industry-leading solutions for customers and members nationwide. Our model combines data-driven processes with the expertise of highly trained clinical and concierge member services, creating a trusted partner in health. We're excited to have you join our journey to change the way healthcare is delivered today.
Job Summary
We're seeking an experienced Case Manager RN to join our Aetna One Advocacy team in Arizona. As a fully remote role, you'll have the flexibility to work from anywhere, with occasional in-office workdays scheduled in advance. This position requires a strong and diverse skillset in relevant areas to drive success. You'll be responsible for assessing, planning, implementing, and coordinating case management activities with members to evaluate their medical needs and facilitate overall wellness.
Key Responsibilities:
- Develop a proactive course of action to address issues presented, enhancing short and long-term outcomes, and opportunities to improve member wellness through integration.
- Conduct evaluations of member needs and benefit plan eligibility, facilitating integrative functions and smooth transitions to Aetna programs and plans.
- Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers, addressing complex health and social indicators impacting care planning and resolution of member issues.
- Assessments consider information from various sources, addressing all conditions, including co-morbid and multiple diagnoses that impact functionality.
- Review prior claims to address potential impact on current case management and eligibility.
- Assess 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.
- Consult with supervisor and others in overcoming barriers in meeting goals and objectives, presenting cases at case conferences for multidisciplinary focus to benefit overall claim management.
- Utilize case management processes in compliance with regulatory and company policies and procedures.
- Utilize interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Requirements:
Education and Licensure:
- A Registered Nurse with an unrestricted license in their state of residence, with multi-state/compact privileges, and willing and able to be licensed in all non-compact states.
- Upon hire, it will be required to obtain all 50 state licenses.
- Associates Degree in Nursing required; BSN preferred.
Experience:
- 3+ years of clinical practice experience required as an RN.
Location:
- There is a requirement to live within a commutable distance of Chandler, Arizona (typically within 45 minutes maximum).
Preferred Qualifications:
Certifications:
- Certified Case Manager (CCM) certification.
Experience:
- Case Management in an integrated model.
What We Offer:
Compensation:
- The typical pay range for this role is: $54,095.60 - $116,760.80.
- 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.
Benefits:
- A full range of medical, dental, and vision benefits.
- Eligible employees may enroll in the Company's 401(k) retirement savings plan.
- An Employee Stock Purchase Plan is also available for eligible employees.
- A fully-paid term life insurance plan to eligible employees.
- Short-term and long-term disability benefits.
- Numerous well-being programs, education assistance, free development courses.
- A CVS store discount and discount programs with participating partners.
- Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.
Career Growth Opportunities:
At CVS Health, we're committed to helping our colleagues grow and develop their careers. We offer:
- Opportunities for professional growth and advancement.
- Training and development programs to enhance your skills.
- A culture that encourages learning and innovation.
Work Environment and Culture:
Our work environment is designed to support the well-being of our colleagues and the communities we serve. We offer:
- A flexible work environment, with remote work options.
- A culture that values diversity, equity, and inclusion.
- A commitment to community engagement and social responsibility.
How to Apply:
If you're a motivated and compassionate RN looking to make a difference in the lives of our members, we encourage you to apply for this exciting opportunity. Please submit your application without delay.
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Application Window:
The application window for this opening will close on: 01/31/2025.
Equal Employment Opportunity:
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.
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