Telephonic Quality Outreach Professional in United States

Become a part of our caring community The Telephonic Quality Outreach Professional supports the EPSDT program requirements in a telephonic outreach environment by evaluating member needs and helping families achieve or maintain an optimal state of wellness. The Telephonic Outreach Care Coach Professional 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically work on straightforward moderate complexity assignments that are routine and structured in nature. The Telephonic Quality Outreach Professional employs a variety of strategies and techniques to coordinate services and resources that facilitate HEDIS gap closure and improve pediatric health outcomes. The supervisor limits decisions to defined parameters around work expectations, quality standards, priorities and timing, and supervises closely and/or works within established policies/practices and guidelines with minimal opportunity for deviation. Position Responsibilities: Telephonic outreach to close HEDIS gaps for Medicaid pediatric population Assist members in addressing barriers to care, including scheduling challenges and transportation needs, to support access to primary care and overall well-being Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator related to strategic outreach to maximize HEDIS outcomes Collaborate with other departments Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs Other responsibilities as assigned Use your skills to make an impact Required Qualifications Unrestricted Licensed Practical Nurse (LPN) in

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. ••work from Home- Candidate may reside in Texas or Arizona•• At CVS Health, we believe we can change the world by improving patient lives, one call at a time. Our Telephonic Registered Nurses (RN) have patient contact in the uniqueness of a telephonic practice setting, where they are impacting lives across the country. You will continue to experience the reasons you became a nurse without having to be in a bedside patient care environment. Working from home, you will be part of a specialized team on the cutting edge of patient care. Working collaboratively with health care professionals, you will provide a meaningful patient experience, while using your critical thinking skills to develop, implement, and evaluate comprehensive plans of care for multiple disease state patients. As a Telephonic Registered Nurse, you will a profound effect on the lives of the patients and caregivers via each outbound call, providing education and support for their new medication. Along with the Compliance and Persistency team, you are the continuity of care supporting defined patient populations through the use of our state-of-the-art telecommunications nursing outreach programs. To be successful in this Registered Nurse position, you must have excellent written and verbal customer service skills, as well as advanced computer skills in order to interact with patients. Our Registered Nurses redefine the way

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job Purpose and Summary As an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly those with social determinants of health (SDoH) needs and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants to support the member in maintaining optimal health. This is achieved by evaluating the members’ needs through the completion of the annual Health Risk Assessment Survey, addressing SDoH needs, and closing gaps in preventative and health maintenance care. Key Responsibilities Telephonic Engagement: Dedicate 50-75% of the day to engaging with members and coordinating their care. Member Outreach: Utilize all available resources to connect with and engage “hard-to-reach” members. Care Planning: Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs. Documentation: Maintain meticulous documentation of care management activities in the member’s electronic health record. Collaboration: Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable h

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: Registered Nurse Case Manager – Field in Danville & Martinsville, VA Schedule: Monday–Friday, 8:00 AM – 5:00 PM EST We’re looking for a compassionate and motivated Registered Nurse Case Manager to join our team, supporting members in the Danville & Martinsville, Virginia area. This is a field-based role that blends in-person visits with telephonic outreach to deliver coordinated, patient-centered care. What You’ll Do: As a Nurse Case Manager, you will play a critical role in improving the health and well-being of members by coordinating care, removing barriers, and supporting better outcomes. In this role, you will: Conduct comprehensive assessments (telephonic and face-to-face) to evaluate members’ medical, behavioral, and social needs Develop and implement personalized care plans that promote both short- and long-term wellness Coordinate care across providers, programs, and services to ensure a seamless experience for members Use clinical expertise and data insights to identify risks, gaps in care, and opportunities for intervention Support members with complex or multiple conditions by applying a holistic

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. RN Nurse Case Manager – Field- Location: Northern Virginia: Fairfax, Sterling, Reston, Ashburn and surrounding Virginia Areas Schedule: Mon-Fri 8:00-5:00 PM EST Travel: Up to75% Position Overview: We’re looking for a compassionate and motivated Registered Nurse Case Manager to join our team, supporting members in the Fairfax, Sterling, Reston, Ashburn and surrounding areas of Virginia. This is a field-based role that blends in-person visits with telephonic outreach to deliver coordinated, patient-centered care. What You’ll Do: As a Nurse Case Manager, you will play a critical role in improving the health and well-being of members by coordinating care, removing barriers, and supporting better outcomes. In this role, you will: Conduct comprehensive assessments (telephonic and face-to-face) to evaluate members’ medical, behavioral, and social needs Develop and implement personalized care plans that promote both short- and long-term wellness Coordinate care across providers, programs, and services to ensure a seamless experience for members Use clinical expertise and data insights to identify risks, gaps in care, and opportunities for intervention Support members with complex or multiple conditions by applying a holistic, whole-person app

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in person or telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of the member to facilitate and support the member’s improved health. The Case Manager 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. Services strategies policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the Two Rivers Region. Qualified candidates must reside in one of the counties within Two Rivers (Union, Webster, Henderson, Daviess, Hancock, McLean, Ohio, Butler, Edmonson, Hart, Warren, Logan, Simpson, Allen, Monroe, Metcalfe, Barren). Evaluation of Members: Through the use of clinical assessment tools and evaluating information/data review, conducts a comprehensi

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and excee

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Location: 89-14 Parsons Blvd, Jamaica, NY 11432 Role Description: The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients. Our Center Nurses report to the Practice Manager. Core Responsibilities: Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits. Execute protocol-driven chronic condition management. Perform skilled nursing procedures including wound care and medication administration (including vaccines). Provide comprehensive patient and caregiver education regarding chronic conditions and

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Medical Assistant Company: Oak Street Health Location: 222-19 Linden Blvd Jamaica, NY 11411 Role Description: The purpose of a Medical Assistant at Oak Street Health is to gather all necessary medical information regarding our patients to ensure providers have the most accurate information available when making healthcare decisions. Medical Assistants (MA) report to the Practice Manager or Center Operations Specialist. They are a vital element of our model and important members of our Care Teams. Being an MA at Oak Street Health requires high levels of flexibility, energy, attention to detail, and problem solving skills. You will be expected to build relationships with Oak Street Health members. Medical Assistants will collaborate closely with their teammates to ensure an unmatched patient experience while driving clinical results. As an MA you will accomplish this by assisting in the assessment of patients’ health conditions, through screenings and routine diagnostic testing performed during appointments. Responsibilities: Ensure an efficient patient flow; room patients in a timely manner, complete vital signs, complete required screenings and complete medication reviews Inventory supplies and stock exam rooms Respond to patient requests for telephonic support (Lab results, faxing

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients. Our Center Nurses report to the Practice Manager. Core Responsibilities: Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits. Execute protocol-driven chronic condition management. Perform skilled nursing procedures including wound care and medication administration (including vaccines). Provide comprehensive patient and caregiver education regarding chronic conditions and preventative care in person, over the

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse Case Manager – Field in Suffolk, Brooklyn, Kings and Queens and surrounding counties, NY Position Summary: This position is a field‑based Registered Nurse (RN) role responsible for conducting member assessments for new NY Better Health enrollees, annual reassessments, semiannual reviews, and change‑in‑condition visits. The nurse will complete 2–3 home visits per day, with all documentation expected within 24 hours of each assessment. The role requires extensive travel (up to 75%) across assigned Suffolk and Surrounding Counties, NY and close collaboration with the Scheduler/CM Assistant who coordinates Work hours are Monday–Friday, 8:30 a.m.–5:00 p.m. EST. Key Responsibilities: Initial Assessments — Conduct member assessments for new NY Better Health applicants. Reassessments — Perform annual, semiannual, and change‑in‑condition assessments per regulatory and plan requirements. Clinical Documentation — Submit complete, accurate documentation within 24 hours of each visit. Care Coordination — Communicate findings to interdisciplinary teams to support care planning. Travel & Scheduling — Maintain punctuality and reliability for 2–3 daily home visits coordinated by the scheduling team. Independent Work — Operate effectively in a remote/telephonic environment while collaboratin

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Medical Social Worker Company: Oak Street Health Role Description: The Medical Social Worker is a key member of Oak Street Health Centers, contributing a unique and valuable perspective to care teams to support the psychosocial needs of our patients. In collaboration with the interdisciplinary care team, they will provide assessments, advocacy, and comprehensive care coordination services to our highest-risk patients and their caregivers to help them improve their health status and avoid hospitalizations. Core Responsibilities: Proactively support our highest-need patients by providing comprehensive assessments, telephonic check-ins, and in-person visits. Partner with the patient and their support persons (if necessary) to identify goals, increase engagement in their healthcare, address barriers, and drive the execution of their care plan. Maintain extensive knowledge of community resources and make referrals, as appropriate, to help ensure the patient's healthcare and psychosocial needs are met. Navigate patient insurance benefits in collaboration with the Patient Relations Manager (PRM) to ensure mindful utilization and maximization of plan benefits Provide both longitudinal and episodic comprehensive care coordination with the ultimate goal of empowering patients to independently manage

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Medical Assistant - Float Company: Oak Street Health Location: Various Role Description: The purpose of a Medical Assistant at Oak Street Health is to gather all necessary medical information regarding our patients to ensure providers have the most accurate information available when making healthcare decisions. Medical Assistants (MA) report to the Practice Manager or Center Operations Specialist. They are a vital element of our model and important members of our Care Teams. Being an MA at Oak Street Health requires high levels of flexibility, energy, attention to detail, and problem solving skills. You will be expected to build relationships with Oak Street Health members. Medical Assistants will collaborate closely with their teammates to ensure an unmatched patient experience while driving clinical results. As an MA you will accomplish this by assisting in the assessment of patients’ health conditions, through screenings and routine diagnostic testing performed during appointments. Responsibilities: Ensure an efficient patient flow; room patients in a timely manner, complete vital signs, complete required screenings and complete medication reviews Inventory supplies and stock exam rooms Respond to patient requests for telephonic support (Lab results, faxing re

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients. Our Center Nurses report to the Practice Manager. Core Responsibilities: Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits. Execute protocol-driven chronic condition management. Perform skilled nursing procedures including wound care and medication administration (including vaccines). Provide comprehensive patient and caregiver education regarding chronic conditions and preventative care in person, over the

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Medical Social Worker Company: Oak Street Health Role Description: The Medical Social Worker is a key member of Oak Street Health Centers, contributing a unique and valuable perspective to care teams to support the psychosocial needs of our patients. In collaboration with the interdisciplinary care team, they will provide assessments, advocacy, and comprehensive care coordination services to our highest-risk patients and their caregivers to help them improve their health status and avoid hospitalizations. Core Responsibilities: Proactively support our highest-need patients by providing comprehensive assessments, telephonic check-ins, and in-person visits. Partner with the patient and their support persons (if necessary) to identify goals, increase engagement in their healthcare, address barriers, and drive the execution of their care plan. Maintain extensive knowledge of community resources and make referrals, as appropriate, to help ensure the patient's healthcare and psychosocial needs are met. Navigate patient insurance benefits in collaboration with the Patient Relations Manager (PRM) to ensure mindful utilization and maximization of plan benefits Provide both longitudinal and episodic comprehensive care coordination with the ultimate goal of empowering patients to independently manage