Clinical Case Manager RN Field - Bilingual - Miami FL
Clinical Case Manager RN Field - Bilingual - Miami FL
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
Bring your heart to CVS Health. Every 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 humancentric 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.
Position Summary
The Care Manager RN is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing planning implementing coordinating monitoring and evaluating). The CM RN utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical and behavioral healthcare through assessment and care planning direct provider coordination/collaboration and coordination of psychosocial wrap around services to promote effective utilization of available resources and optimal costeffective outcomes.
The Case Manager RN is responsible for driving and supporting care management and care coordination activities across the continuum of care (assessing planning implementing coordinating monitoring and evaluating) for a Medicaid population in Dade and Monroe Counties FL.
What you will do
Executes evaluation of member needs and benefit plan eligibility and facilitates member transition to the organizations programs and plans.
Applies advanced clinical judgement to incorporate strategies designed to reduce risk factors and barriers and to address complex health indicators that impact care planning and resolution of member issues.
Handles reviews of prior claims to address potential impact on current case management and eligibility.
Creates a holistic approach to assess the need for referrals to clinical resources and to assist in determining functionality.
Ensures case management processes follow organization and regulatory requirements.
Implements systems to maximize member engagement discern health status and needs and to assess member levels of work capacity and restrictions.
Coaches and trains junior colleagues in techniques processes and responsibilities.
Required Qualifications
- Must reside in Miami Dade FL or a surrounding county
- Bilingual in Creole and/or Spanish
- Active current unrestricted RN licensure in the state of Florida
- 3 years clinical practice experience e.g. hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility
- Willing and able to travel 1020 of their time to meet members face to face in the Miami Dade County and surrounding areas. Reliable transportation required;Mileage is reimbursed per our company expense reimbursement policy
- 2 years experience using personal computer keyboard navigation navigating multiple systems and applications; and using MS Office Suite applications (Teams Outlook Word Excel etc.
Preferred Qualifications
- Chronic disease management preferred (cancer diabetes hypertension chronic kidney disease serious mental illness and/or HIV aids)
- Case management in an integrated model preferred
- Managed care experience
- Discharge planning experience
- Experience providing care to the Medicaid population
Education
- Associates degree or Diploma in Nursing required
- BSN preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54095.00 $116760.00This pay range represents the base hourly rate or base annual fulltime 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 shortterm incentive program in addition to the base pay range listed above.
In addition to your compensation enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical dental and vision benefits. Eligible employees may enroll in the Companys 401(k) retirement savings plan and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fullypaid term life insurance plan to eligible employees and shortterm and long term disability benefits. CVS Health also offers numerous wellbeing programs education assistance free development courses a CVS store discount and discount programs with participating partners. As for time off Company employees enjoy Paid Time Off (PTO) or vacation pay as well as paid holidays throughout the calendar year. Number of paid holidays sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits please visit Benefits CVS Health
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws.
CVS Health requires certain colleagues to be fully vaccinated against COVID19 (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 COVID19 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. CVS Health is committed to recruiting hiring developing advancing and retaining individuals with disabilities. As such we strive to provide equal access to the benefits and privileges of employment including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation including a qualified interpreter written information in other formats translation or other services through If you have a speech or hearing disability please call 711 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.Required Experience:
Manager
Employment Type
Full-Time
