Case Manager II at CVS Health | Torre
Case Manager II
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CVS Health

Case Manager II

CVS Health
Posted by
Vikas Jain
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Emma
Emma
You'll elevate patient care and transform lives for dual-eligible members across Illinois.
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Full-time

Legal agreement: Contractor

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Compensation
USD32 - 35.7/hour
Negotiable
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Remote (anywhere)
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Posted 9 days ago

Requirements and responsibilities

Job Title: Nurse Case Manager II Estimated Length of Assignment: 03+ Months (with possible extension) (The dates provided are only an estimate and not a guarantee) Est. Pay Range: $32.00/hour – $35.07/Hour on W2 (USD) (all inclusive) Negotiable Work Type: mostly WFH with some member visits in the area they live as needed Schedule: 8am to 5pm CST Mon-Fri Job Details: Candidates can live anywhere in IL. This is a hybrid role; they will be mostly WFH with some member visits in the area they live as needed. REQUIRED Telephonic (Hybrid) Case Managers: Caseloads range from 250 to 500 members, depending on member stratification levels and complexity of needs. Field Based Case Managers: Caseloads typically range from 30 to 100 members, depending on market needs and complexity of member’s needs. Help us elevate our patient care to a whole new level! 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 life-changing impact on our members who are enrolled in Medicare and Medicaid and 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 our members’ 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. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Experience with case management and IL waiver services is preferred. -Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services -Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits -Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures Experience •Minimum 3-5 years clinical practical experience required •Minimum 2-3 years Care Management, discharge planning and/or home health care coordination experience preferred •Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually •Excellent analytical and problem-solving skills •Effective communications, organizational, and interpersonal skills .•Ability to work independently •Effective computer skills including navigating multiple systems and keyboarding •Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications Position Summary The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Education: Requires RN, LCSW, or LCPC with unrestricted active license in IL. Case Management Certification CCM preferred
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