Case Manager, Registered Nurse

Job not on LinkedIn

🔥 41 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $54.1k - $142.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Coordinate and facilitate comprehensive care by assessing member needs, developing personalized care plans, and coordinating services across healthcare providers • Advocate for patients and ensure effective communication, resource utilization, and continuous progress monitoring • Act as liaison among members/clients/families, employers, providers, insurance companies, and healthcare personnel • Coordinate case management activities for catastrophic cases and chronically ill members across the continuum of care • Arrange consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members by telephone or in person, including visits to homes, worksites, or physician offices when required • Assess medical and vocational status and develop care plans to optimize wellness, medical outcomes, return to work, and functional outcomes • Communicate with medical providers, attorneys, employers, and insurance carriers • Prepare required casework documentation • Consult with internal multidisciplinary teams • Contact treating physicians or specialists regarding care and treatment • Provide education and prevention information • Apply laws, regulations, insurer instructions, and company policies governing rehabilitation and case management • Evaluate needs and benefit-plan eligibility using clinical tools and data • Develop proactive action plans and monitor progress toward desired outcomes

🎯 Requirements

• Active and unrestricted Compact Registered Nurse (RN) Licensure in the state of residence (PA, OH, FL, NJ, GA, NC, TX, CT) • 3+ years of clinical practical experience preferred, including diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, or home health, with Medicare members • 2+ years of case management, discharge planning and/or home health care coordination experience • Proficiency with Microsoft Word, Excel, Outlook, PowerPoint, and proprietary applications • Ability to work in a fast-paced, high-volume environment using time management and prioritization skills • Efficient computer skills, including navigating multiple systems and keyboarding • Working knowledge of problem-solving and decision-making skills • Working knowledge of medical terminology • Working knowledge of digital literacy skills • Ability to deal tactfully with customers and community • Ability to handle sensitive information ethically and responsibly • Ability to evaluate relative costs and benefits of potential actions • National professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred • Excellent analytical and problem-solving skills preferred • Effective communication, organizational, and interpersonal skills preferred • Bilingual Spanish preferred • Associate's Degree in Nursing required • Bachelor's Degree in Nursing preferred • Direct/hardwired internet connection within 7 feet of the modem/router, with minimum 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Ability to work within the state and city where currently living • Ability to use multiple monitors and applications • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals and follow security practices • Ability to troubleshoot common technical issues and contact IT when necessary • Openness to learning new skills as the workplace evolves

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay • Company-provided equipment (keyboard, monitor, computer, headset, etc.)

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