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Nurse Care Coordinator
2 months ago
Join CVS Health in our mission to enhance health care delivery. Our commitment is to provide personalized, accessible, and affordable health care solutions that resonate with our core values. We believe that the manner in which we deliver our services is as crucial as the services themselves, and we strive to empower our team members to contribute to a culture of innovation and transformation.
Position Overview: The Nurse Care Coordinator plays a vital role in assessing, planning, implementing, and managing case management activities for members. This position focuses on evaluating the medical requirements of members to promote their overall health and well-being. The Nurse Care Coordinator will develop proactive strategies to address challenges and enhance both short-term and long-term health outcomes.
Key Responsibilities:
- Conduct comprehensive evaluations of member needs and eligibility for benefits, facilitating smooth transitions to organizational programs.
- Utilize advanced clinical judgment to implement strategies aimed at mitigating risk factors and addressing complex health indicators that influence care planning.
- Review historical claims to assess their potential impact on current case management and eligibility.
- Adopt a holistic approach to determine the necessity for referrals to clinical resources, aiding in the assessment of functionality.
- Ensure compliance with organizational and regulatory standards throughout the case management process.
- Develop systems to enhance member engagement, assess health status, and evaluate work capacity and limitations.
- Provide mentorship and training to junior staff on case management techniques and responsibilities.
Qualifications:
- Possession of an active and unrestricted RN license.
- A minimum of three years of clinical experience.
- Willingness to travel as required to meet members in various locations.
Preferred Qualifications:
- Experience in case management.
- Bilingual proficiency in Spanish.
- Associate's degree or Diploma in Nursing; Bachelor's degree preferred.
Compensation and Benefits: The compensation for this role is competitive and commensurate with experience. In addition to a comprehensive benefits package, CVS Health offers various programs to support the well-being of our employees, including medical, dental, and vision coverage, retirement savings plans, and paid time off.
Commitment to Diversity: CVS Health is an equal opportunity employer, dedicated to fostering an inclusive environment for all employees. We value diversity and strive to provide equal access to employment opportunities for individuals from all backgrounds.
