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CVS HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in case management activities, including assessment, planning, and implementation of care strategies while utilizing clinical judgment to enhance member outcomes. Proficient in evaluating medical needs and facilitating transitions to programs, with a strong emphasis on compliance and effective communication.
Highest-signal resume keywords
Registered Nurse License5+ Years Acute Care ExperienceCase Management ProcessesCCM CertificationMotivational Interviewing Skills
About the role
Key responsibilities & impact- Telephonically and/or face to face assess, plan, implement, and coordinate case management activities with members
- Evaluate members’ medical needs to facilitate overall wellness
- Develop proactive courses of action addressing issues and enhancing short- and long-term outcomes
- Use clinical tools and information/data review to evaluate member needs and benefit plan eligibility
- Facilitate integrative functions and smooth transitions to Aetna programs and plans
- Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators
- Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions/limitations
- Review prior claims for potential impact on current case management and eligibility
- Assess the need for referrals to clinical resources
- Consult with supervisors and others to overcome barriers and present cases at multidisciplinary case conferences
- Use case management processes in compliance with regulatory and company policies and procedures
- Utilize motivational interviewing skills to maximize member engagement and discern health status
Requirements
What you’ll need- Active, current, and unrestricted Registered Nurse license in state of residence
- Willingness and ability to obtain additional state licenses upon hire
- 5+ years of acute care experience as an RN
- Willingness and ability to work Monday through Friday, 8:00am–4:30pm in the time zone of residence, with occasional late-shift rotation from 10:30am–7:00pm EST
- Strong computer skills
- Microsoft Suite familiarity
- Associate's degree with RN licensure required
- Compact State licensure preferred
- CCM certification preferred
- Care case management experience preferred
- Home Care experience preferred
- Spanish speaking/bilingual preferred
- Oncology experience/background preferred
Benefits
Comp & perks- Company-paid additional state licenses upon hire
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program eligibility
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case ManagementClinical AssessmentCare PlanningData ReviewRisk Factor ReductionReferral AssessmentCo-Morbidity EvaluationHealth Status EvaluationOutcome EnhancementFunctionality Assessment
Soft Skills
Communication SkillsInterpersonal SkillsProblem-Solving SkillsTeam CollaborationMember Engagement
Tools & Technologies
Microsoft SuiteClinical Tools
Certifications & Qualifications
CCM CertificationRegistered Nurse License
Industry Keywords
Acute CareHome CareOncologyBilingual SpanishCompact State Licensure