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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 and clinical assessment, utilizing strong Registered Nurse licensure and critical care experience to improve patient outcomes. Proficient in navigating healthcare systems and employing effective communication and technical skills in a virtual work environment.
Highest-signal resume keywords
Registered Nurse (RN) LicensureCritical Care ExperienceCase Management ExperienceClinical Assessment SkillsMicrosoft Office 365 Proficiency
About the role
Key responsibilities & impact- Assess, plan, implement, and coordinate case management activities telephonically and/or face to face
- Evaluate members’ medical needs and facilitate overall wellness
- Develop proactive courses of action to improve short- and long-term outcomes
- Review clinical tools, information, data, benefit plan eligibility, and prior claims
- Facilitate transitions to Aetna programs and plans
- Apply clinical judgment to reduce risk factors and address complex health and social indicators
- Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations
- Refer members to clinical resources when needed
- Consult with supervisors and colleagues to overcome barriers and meet goals
- Present cases at multidisciplinary case conferences
- Follow case management processes and regulatory and company policies
- Use interviewing skills to engage members and assess health status and needs
- Perform blended Case Management and Utilization Management duties for Aetna’s National Medical Excellence team
Requirements
What you’ll need- Active, current and unrestricted compact Registered Nurse (RN) licensure in the state of residence
- 5 years clinical practice experience as a Registered Nurse (RN)
- 2+ years’ experience in critical care
- 6+ months case management or utilization management experience
- Must be able to work Monday–Friday, 8 AM to 5 PM in the time zone of residence
- Must be able to obtain multi-state Registered Nurse (RN) licensures
- Associate's Degree in Nursing (REQUIRED)
- Direct/hardwired internet connection to a modem/router within 7 feet of the computer
- Minimum internet speed of 25 Mbps download and 3 Mbps upload
- WiFi and satellite internet are not permitted
- Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
- Must work within the state and city where currently living
- Must provide own workspace furniture
- Experience setting up and using multiple monitors and navigating multiple applications
- Ability to use email, calendar invites, Teams messaging, and virtual meetings
- Experience with Microsoft Office 365 or similar Google Workspace applications
- Ability to log in to secure systems such as VPN and EHR portals
- Ability to manage strong passwords and recognize suspicious emails or links
- Ability to troubleshoot common technical issues independently
- Openness to learning new skills
- Preferred: Case Management Certification
- Preferred: Transplant experience
- Bachelor's Degree in Nursing (PREFERRED)
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- Company-provided equipment including keyboard, monitor, computer, and headset
- Remote work from home
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 ManagementUtilization ManagementClinical JudgmentPatient AssessmentData ReviewCo-Morbidity AssessmentTransplant ExperienceTechnical TroubleshootingEHR NavigationInternet Speed Management
Soft Skills
Communication SkillsInterpersonal SkillsProblem-Solving SkillsOpenness to LearningTeam Collaboration
Tools & Technologies
Microsoft Office 365Google WorkspaceVPNEHR PortalsTeams Messaging
Certifications & Qualifications
Case Management CertificationRegistered Nurse (RN) Licensure
Industry Keywords
HealthcarePatient WellnessHIPAA ComplianceClinical ResourcesMultidisciplinary Case Conferences