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Job Information

CVS Health Nurse Case Manager RN in Michigan

Job Description

Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. 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 member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.The Case Manager is responsible for assessment, development and implementation using comprehensive assessments of members enrolled in Medicaid Managed Care.-The Case Manager will coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant. The Case Manager will attend interdisciplinary meetings and advocate on members behalf.-The Case Manager works with the member and care team to develop care plans and supports through internal resources.The Case Manager will also work with the member and care team to coordinate and assist with community resources.The Case Manager is responsible for documenting accurately and timely in the electronic health record. This position requires the care manager to use critical thinking and be able to problem solve any issues related to assigned membership.

Required Qualifications

5 years clinical practice experience requiredRN with current unrestricted state licensure required.10-20% travel required in Wayne, Macomb and Oakland Counties in the Detroit Metropolitan Area

Preferred Qualifications

Case Management in an integrated model preferredBilingual preferred


Associate's degree or equivalent experience

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.