Case Manager, RN

Vaga não está no LinkedIn

🕒 4 dias atrás

🌲 North Carolina – Remoto

🌲 North Carolina – Remote

💵 $54.095 - $129.615 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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CVS Health

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1963

🏥 Saúde

⚕️ Seguro de Saúde

🛒 Varejo

Healthcare • Healthcare Insurance • Retail

CVS Health é uma empresa líder de saúde nos Estados Unidos, dedicada a ampliar o acesso e a acessibilidade ao cuidado. A empresa adota uma abordagem abrangente que inclui serviços de saúde, seguro saúde e gestão de benefícios farmacêuticos (PBM). Por meio de suas subsidiárias, como Aetna e CVS Caremark, a CVS Health oferece uma variedade de serviços que promovem o bem-estar, a gestão de condições de saúde e a cobertura acessível de medicamentos prescritos. A CVS Health opera farmácias de bairro, oferece serviços de farmácia por correspondência e gerencia programas de medicamentos de especialidade, com o objetivo de tornar o cuidado com a saúde conveniente e acessível para todos. Movida pela missão de conectar pessoas a serviços essenciais de cuidado, a CVS Health está comprometida em fomentar comunidades mais saudáveis e apoiar o bem-estar de todas as pessoas.

Descrição

• Assess members’ health status and care coordination needs • Conduct inpatient review and discharge planning • Develop, implement, monitor, and evaluate case management plans • Involve the Medical Director when indicated • Close cases when members meet discharge criteria • Use data-driven methods to identify members for individualized case management programs or alternative healthcare referrals • Conduct comprehensive clinical assessments • Evaluate needs and develop approaches based on member needs, benefit plans, and external programs/services • Advocate for patients within existing healthcare coverage • Promote quality, cost-effective outcomes and suggest program or operational improvements • Identify and escalate quality-of-care issues through established channels • Provide a high level of customer service • Assess health literacy, technology capabilities, and readiness to change • Use influencing and motivational interviewing to engage members and promote lifestyle or behavior changes • Provide coaching, information, education, and support to empower independent medical and healthy-lifestyle choices • Collaborate with members, healthcare resources, and the Medical Director as appropriate

🎯 Requisitos

• Active, current, and unrestricted RN license in state of residence • Willingness and ability to obtain additional state licenses upon hire • 3+ 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 an occasional late shift rotation of 11:00am–8:00pm EST once per quarter • Associate Degree required • Compact RN License or multi-state licensure preferred • Certified Case Manager (CCM) preferred • Managed Care experience preferred • Hospital experience in ICU, CCU, Step Down, ER, or OR preferred • Telephonic case management and/or telephonic experience preferred • 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 • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to provide own workspace furniture • Ability to use multiple monitors and navigate multiple applications • Ability to use email, calendar invites, Teams, virtual meetings, and Microsoft Office 365 or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals, maintain strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently

🏖️ Benefícios

• 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 (keyboard, monitor, computer, headset, etc.) • Company-paid additional state licenses obtained after hire • Flexible work from home arrangement

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