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CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Case Manager Registered Nurse, Assessor Team
Location
Illinois
Posted
99 days ago
Salary
$66.6K - $142.6K / year
Seniority
Senior
Job Description
Case Manager Registered Nurse, Assessor Team
CVS Health
• Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings • Analyzes complex patient data from medical history, diagnostic test results, and treatment plans, to understand the current health status of the patient • Applies in-depth knowledge of case management and nursing practices to organize patient files in an orderly manner for easy retrieval • Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans • Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care • Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient progress and manages specific conditions • Coordinates analytics projects to enable case managers to analyze data and generate reports on key performance health indicators • Designs complex processes to coordinate discharge planning in a safe and timely transition from the hospital to home • Develops resource management to help case managers optimize healthcare with community resources
Job Requirements
- 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
- Registered Nurse (RN) certification required in Illinois
- Working knowledge of problem solving and decision making skills
- Working knowledge of medical terminology
- Working knowledge of digital literacy skills
- Ability to deal tactfully with customers and community
- Ability to handle sensitive information ethically and responsibly
- Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option
- Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients
- Certified Case Manager is preferred
- Bilingual preferred
- Associates required, Bachelor's preferred
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
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Call 4 HealthCall 4 Health is an Equal Opportunity Employer (EEO). We are committed to providing a workplace free of discrimination and harassment and to creating an inclusive environment for all employees.
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Team Lead is responsible for supporting day-to-day Patient Access operations in a remote call center environment. This includes: - Monitoring real-time performance - Ensuring schedule adherence - Coaching and developing team members - Maintaining quality, productivity, and client/patient experience standards The Team Lead works closely with Floor Managers, Workforce Management (WFM), Quality Assurance (QA), and Training teams to ensure coverage and consistent execution of Call 4 Health policies and client requirements. Qualifications - Associate’s degree in Business Administration, Healthcare Administration, or related field (or equivalent combination of education and experience) - Prior call center or customer service experience required; healthcare call center experience preferred - Previous Team Lead, Supervisor, or equivalent leadership experience preferred Requirements - Monitor real-time production and service levels (queues, wait times, dashboards) and escalate risks to coverage or performance as needed - Support schedule adherence by verifying log-in readiness at shift start, monitoring adherence throughout the day, and coordinating with WFM/Floor Manager to address variances - Provide day-to-day supervision of assigned Patient Access Representatives (PCRs), including coaching, reinforcement of expectations, and recognition - Deliver timely performance feedback on quality, productivity, adherence, and attendance; document coaching discussions per company procedures - Reinforce call quality by ensuring compliance with scripts, verification, and documentation standards; partner with QA/Training for targeted coaching and re-training as needed - Handle escalations from patients or clients professionally and promptly; document outcomes and ensure appropriate follow-up - Maintain accurate records of attendance, tardiness, and schedule variances; ensure employees follow call-out procedures and escalation requirements - Create and manage tickets in the Call 4 Health system; track to resolution and communicate updates to stakeholders - Prepare and provide routine operational updates to the Floor Manager (e.g., attendance trends, performance risks, coaching activity, escalation themes) - Assist with onboarding, mentoring, and shadowing of new hires; reinforce performance expectations and operational standards - Support annual and periodic performance review processes as assigned, including collection of performance data and documented feedback - Perform other duties as assigned based on department, client, or company needs Supervisory Responsibilities - Provide day-to-day guidance, coaching, and performance oversight for up to approximately 15 employees (or as assigned) - Assist with selection, onboarding, training reinforcement, and performance assessment in partnership with the Floor Manager Knowledge, Skills, and Abilities - Strong written and verbal communication skills; professional customer service presence - Ability to coach, motivate, and hold employees accountable while maintaining a respectful, supportive approach - Ability to multitask and prioritize in a fast-paced, real-time production environment - Proficient with computers and business systems; able to navigate multiple applications simultaneously (phone system, EHR/client portals, ticketing, reporting) - Data-driven approach: ability to interpret reports and metrics and translate them into coaching actions and operational improvements - Dependable attendance and punctuality; consistent adherence to schedules and operational needs - Team-oriented, receptive to feedback, and committed to continuous improvement Tools and Equipment Used - Computer (word processing, spreadsheets, email, database/web applications) - Phone/softphone and headset - Printer/scanner (as applicable) - Other standard office or remote work equipment Remote Work Requirements - Maintain a private, professional, distraction- and noise-free workspace to protect confidentiality and support call quality - Ensure calls cannot be overheard by others; follow all confidentiality and security procedures for systems and data access - Be camera-ready for required trainings and meetings - Comply with dress code requirements for the role (business casual for Team Leads, unless otherwise directed) Physical Requirements - Frequent sitting for extended periods; talking, hearing, and viewing computer monitors - Occasional standing or walking; use of hands for keyboarding and operating office equipment - Ability to communicate effectively via phone and video conferencing Work Environment - Fast-paced, metrics-driven call center environment (remote and/or office) with frequent changes based on client and business needs - Ability to maintain professional working relationships with individuals of varying personalities and communication styles - Ability to manage stress and respond calmly to escalations and shifting priorities Disclaimer This job description is not intended to be an exhaustive list of duties, responsibilities, or qualifications. It may be modified at any time, with or without notice, based on department, client, and/or company needs.



