Case Manager, Registered Nurse

Job not on LinkedIn

🕒 October 6

🏈 Alabama, Florida, +7 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote 🐎 Kentucky – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🎸 Mississippi – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote ⚔️ Virginia – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 13%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Facilitate delivery of appropriate benefits and healthcare information determining benefit eligibility • Promote wellness activities and support Health Strategies, tactics, policies, and programs • Perform assessment, planning, facilitation, care coordination, evaluation, and advocacy for members’ and families’ comprehensive health needs • Act as liaison among members/clients/families, employers, providers, insurers, and healthcare personnel • Coordinate case management activities for catastrophic cases and chronically ill members across the continuum of care • Coordinate consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members/clients telephonically or in person, including at homes, worksites, or physician offices • Assess medical and vocational status and develop plans of care • Communicate with medical providers, attorneys, employers, and insurance carriers • Prepare required case work documentation • Consult with internal multidisciplinary teams and treating physicians or specialists • Provide educational and prevention information • Apply laws, regulations, insurer instructions, and referral-source requirements • Evaluate member needs and benefit-plan eligibility using clinical tools and data • Monitor progress toward desired outcomes through assessment and evaluation • Develop proactive courses of action to improve short- and long-term outcomes, wellness, function, and return to work

🎯 Requirements

• Candidates must reside in the Southeast Region (FL, GA, AL, MS, NC, SC, TN, OH, AK, KY, VA) • Active and unrestricted Compact Registered Nurse (RN) license and live in compact state • 3+ years clinical practical experience • 2+ years case management, discharge planning and/or home health care coordination experience • Dependents must have separate care arrangements during work hours • Access to a private, dedicated space to conduct work effectively • Associate's Degree in Nursing (REQUIRED) • Bachelor's Degree in Nursing (PREFERRED) • Willing and able to obtain multi state Registered Nurse (RN) licenses if needed • Direct/hardwired internet connection to a modem/router within 7 feet of computer • Minimum internet speed of 25mbs download and 3mbs upload • Quiet, secure and private designated home virtual work location compliant with CVS Health and HIPAA guidelines • Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace • Ability to log in to secure systems such as VPN and EHR portal • Ability to manage strong passwords and recognize suspicious emails or links • Ability to resolve common technical issues independently • Efficient computer skills and keyboarding • Preferred: Certified Case Manager • Preferred: National professional certification (CRC, CDMS, CRRN, COHN, or CCM) • Preferred: Excellent analytical and problem-solving skills • Preferred: Effective communication, organizational, and interpersonal skills • Preferred: Ability to work independently • Preferred: Clinical experience in diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, or home health with Medicare members

🏖️ Benefits

• 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.)

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