Case Manager, Registered Nurse

Job not on LinkedIn

🔥 12 hours ago

🏈 Alabama, Florida, +8 more states – Remote

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

💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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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

• Assess, plan, facilitate, coordinate, evaluate, and advocate for options and services addressing comprehensive member and family health needs • Act as liaison among members/clients/families, employers, providers, insurance companies, attorneys, and healthcare personnel • Implement and coordinate case management activities for catastrophic cases and chronically ill members/clients across the continuum of care • Interact with members/clients telephonically or in person, including possible visits to homes, worksites, or physician offices • Assess and analyze medical and/or vocational status and develop plans of care • Facilitate condition management, wellness, medical outcomes, return to work, optimal functioning, and benefits eligibility • Communicate with members/clients and other stakeholders regarding care and treatment • Prepare required case work documentation • Consult with internal multidisciplinary teams and treating physicians or specialists • Provide education and prevention information • Apply applicable rehabilitation-service laws, regulations, insurer instructions, and referral-source requirements • Testify as required to substantiate case work or reports • Evaluate needs and benefit-plan eligibility using clinical tools and data • Monitor member/client progress toward desired outcomes through assessment and evaluation • Develop proactive courses of action to improve short- and long-term outcomes and overall wellness

🎯 Requirements

• Candidate must reside in the South Region: OH, VA, NC, KY, TN, SC, GA, AL, MS, AR, LA, FL • Active and unrestricted Compact Registered Nurse (RN) licensure in OH or the state of residence • 3+ years of clinical practical experience preferred, including diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac experience with Medicare members • 2+ years of case management, discharge planning, and/or home health care coordination experience • Bilingual Spanish preferred • Excellent analytical and problem-solving skills • Effective communication, organizational, and interpersonal skills • Ability to work independently, potentially from home • Proficiency with MS Word, Excel, Outlook, PowerPoint, and proprietary applications • Efficient computer skills, including navigating multiple systems and keyboarding • Willingness and ability to obtain multi-state RN licenses if needed • Certified Case Manager national professional certification (CRC, CDMS, CRRN, COHN, or CCM) • Associate's Degree or Nursing Diploma required • Bachelor's Degree preferred • Direct/hardwired internet connection within 7 feet of the computer, with minimum 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted • Quiet, secure, private, distraction-free home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide own workspace furniture • Ability to set up and use multiple monitors and navigate multiple applications • Ability to use email, calendar invites, Teams, virtual meetings, Microsoft Office 365 or Google Workspace • Ability to log into secure systems such as VPN and EHR portals, secure computers, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues and contact IT when needed • Openness to learning new skills as the workplace evolves

🏖️ 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.) • Company will provide support for obtaining multi-state Registered Nurse licenses if needed