Hybrid Case Manager RN- Greenville, SC

CVS Health



Columbia, SC

Why you should apply for a job to CVS Health:

  • 62% say women are treated fairly and equally to men
  • 52% say the CEO supports gender diversity
  • Ratings are based on anonymous reviews by Fairygodboss members.


    Position summary

    chedule is Monday-Friday; will work between 8am - 8pm EST.**

    CVS Accountable Care Hybrid Case Manager uses a collaborative process of assessment, planning, facilitation, care coordination,
    evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication
    and available resources to promote quality, cost effective outcomes.

    Acts as a liaison with beneficiary, family, provider(s), and healthcare personnel as appropriate.
    • Implements and coordinates all case management activities relating to catastrophic cases and chronically ill beneficiary across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
    • Interacts with beneficiaries telephonically or in person. May be required to meet with
    beneficiaries in their homes, physician's office, or CVS Health Hub to provide ongoing case
    management 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., medical
    providers, 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 policies
    and procedures.
    • Facilitates appropriate condition management, optimize overall wellness and medical
    outcomes, 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 short
    and long-term outcomes, as well as opportunities to enhance a beneficiary's overall
    wellness through integration.
    • Monitors beneficiary progress toward desired outcomes through assessment and

    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% throughout various areas of Greenville, SC. and most be willing to travel up to 60 miles or 60 mins.

    • Reliable transportation required

    • Mileage is reimbursed per our company expense reimbursement policy

    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

    • Bilingual Spanish and English preferred.


    Diploma or Associates Degree in Nursing or higher

    Pay Range

    The typical pay range for this role is:

    $54,095.60 - $116,800.00

    This pay range represents the base hourly rate or base annual full-time 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 short-term 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 Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being 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 jobs.CVSHealth.com/benefits

    We anticipate the application window for this opening will close on: 07/31/2024

    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. 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 [email protected] If you have a speech or hearing disability, please call 7-1-1 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.

    Why you should apply for a job to CVS Health:

  • 62% say women are treated fairly and equally to men
  • 52% say the CEO supports gender diversity
  • Ratings are based on anonymous reviews by Fairygodboss members.