At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Job Description:
- Candidate must transition a minimum 3 members per month from nursing facility to community
- Candidate must utilize workflows, processes, and critical thinking to ensure member remains in community for 6 months post transition
- Actively engage in preventive care efforts by scheduling and confirming member appointments, coordinating transportation, and promoting adherence to care plans.
- Implement strategies to reduce avoidable emergency department visits and hospital admissions through early intervention and education.
- Provide enhanced member education on in-home safety measures, including fall prevention and medication adherence.
- When appropriate, accompany members to medical appointments to support care continuity and ensure understanding of treatment plans.
- Applies critical thinking, evidence-based clinical criteria to support contractual rebalancing goals:
- Support the Health Plan Rebalancing Initiative goal of successful transitions: Identify and assess members to transition from the Nursing Facility (NF) setting into the community
- Follow up on CM referrals and visit current NF members in-person twice a week as needed to complete the rebalancing events and assessments.
- Complete telephonic or in-person contact as appropriate to assess the home prior to discharge and identify any environmental supports needed to support transition (i.e. ramp, DME installation etc.).Conduct an in-person Significant Change Visit with member and Rep if applicable, within 7 business days of transition. Coordinate provision of services as needed, establish Plan of Care, and document all actions taken.
- Contact facility's Business Office once a week to follow-up on member's census and coordinate with Social Services and CM to facilitate discharge.
- Work collaboratively with health plan case managers to identify high risk community members and implement appropriate interventions to prevent lapse or coordinate safe transition (Upon receiving referral)
- Drive enhanced value of health care to increase member satisfaction and retention, and drive new membership growth.
- Engage in building strong relationships that contribute towards member satisfaction and retention
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- Active, unrestricted and good standing RN license in the state of New Jersey
- Minimum 2 years of clinical experience
- Experience in all ore some of the following: Managed Care, Discharge coordination, Transition of care, Home Health, Case Management and Medicaid
- Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy
- Must reside in South New Jersey. Camden and Burlington Counties for example.
- Position requires proficiency with computer skills which includes navigating multiple systems
- Ability to work in a fast-paced environment
Associate Degree Required and BSN preferred. Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$34.92 - $74.78This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.