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CVS Health ACO REACH Case Manager RN - Field Chicago Spanish in Illinois

Job Description

SIGNON BONUS $5,000 FOR EXTERNAL APPLICANTSRequirement to reside in Illinois, in or near enough to Chicago to do field work in Chicago area.50-75% of expected travel in Chicago.Working schedule is Monday-Friday; will work between 8am - 8pm CST.ACO REACH Field Case Manager uses a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet anindividual’s and family’s comprehensive health needs through communication andavailable resources to promote quality, cost effective outcomes.Fundamental Components & Physical Requirements• Acts as a liaison with beneficiary, family, provider(s), and healthcare personnel as appropriate.• Implements and coordinates all case management activities relating to catastrophic casesand chronically ill beneficiary across the continuum of care that can includeconsultant referrals, home care visits, the use of community resources, and alternativelevels of care.• Interacts with beneficiaries telephonically or in person. May be required to meet withbeneficiaries in their homes, physician’s office, or CVS Health Hub to provide ongoing casemanagement services.• Assesses and analyzes injured, acute, or chronically ill beneficiaries medical status; In collaboration with the provider partner develops a plan of care to facilitate the beneficiary appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.• Communicates with beneficiary and other stakeholders as appropriate (e.g., medicalproviders, attorneys, community resources) telephonically or in person.• Prepares all required documentation of case work activities as appropriate.• Interacts and consults with internal multidisciplinary team as indicated to help beneficiary maximize best health outcomes.• Collaborate with treating physician or specialists concerning course of care and treatment as appropriate.• Provides educational and prevention information for best medical outcomes.• Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by Medicare and referral sources.• Conducts an evaluation of beneficiary’s needs and facilitates integrative functions using clinical tools and information/data.• Utilizes case management processes in compliance with regulatory and company policiesand procedures.• Facilitates appropriate condition management, optimize overall wellness and medicaloutcomes, appropriate and timely return to baseline, and optimal function or return to work.• Develops a proactive course of action to address issues presented to enhance the shortand long-term outcomes, as well as opportunities to enhance a beneficiary’s overallwellness through integration.• Monitors beneficiary progress toward desired outcomes through assessment andevaluation

Pay Range

The typical pay range for this role is:

Minimum: 58,760

Maximum: 125,840

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

  • A Registered Nurse that must hold an unrestricted license in their state of residence, with multi-state/compact privileges and have the ability to be licensed in all non-compact states. - 3+ years clinical experience required with at least 1 year of experience in one of the following areas: critical care, ICU, CCU, Emergency- 2+ years case management experience required- Must be willing to travel up to 75% in and around Chicago area.- Bilingual Spanish and English required- Reliable transportation required- Mileage is reimbursed per our company expense reimbursement policy

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (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 COVID-19 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.

Preferred Qualifications

  • Managed Care experience preferred- Medicare experience preferred- Advanced Care Planning Experience preferred- CCM Certification- Excellent analytic and problem-solving skills- Ability to work independently (this position will be work from home)-Effective computer skills including navigating multiple systems and keyboarding


  • Associate nursing degree minimum

Business Overview

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 human-centric 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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