Case Manager, Registered Nurse

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🔥 29 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members • develops a proactive course of action to address issues presented to enhance the short and long-term outcomes • conducts an evaluation of member’s needs and benefit plan eligibility • applies clinical judgment to incorporate strategies designed to reduce risk factors • reviews prior claims to address potential impact on current case management • assessments include the member’s level of work capacity • consults with supervisor and others in overcoming barriers • utilizes case management processes in compliance with regulatory and company policies

🎯 Requirements

• Must have an active, current and unrestricted compact RN licensure in the state of residence • 5 years clinical practice experience as an RN • 2+ years’ experience in critical care • 6+ months Case Management or Utilization Management experience • Must be able to work Monday through Friday 8:00am to 5:00pm in the time zone of residence • Must be able to obtain multi state RN licensures (expense paid for by organization)

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility