Case Manager, Registered Nurse

Job not on LinkedIn

🔥 14 hours ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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 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 for individuals by assessing 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/clients 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 and analyze medical and/or vocational status • Develop plans of care to optimize wellness and medical outcomes, support timely return to work, and determine benefit eligibility • Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers • Prepare required case work documentation • Consult with internal multidisciplinary teams • Contact treating physicians or specialists regarding course of care and treatment • Provide education and prevention information • Apply applicable rehabilitation-service laws, regulations, insurer instructions, and referral-source requirements • Evaluate member/client needs and benefit plan eligibility using clinical tools and data • Apply case management processes in compliance with regulatory and company policies • Develop proactive actions to improve short- and long-term outcomes and overall wellness • Monitor progress toward desired outcomes through assessment and evaluation

🎯 Requirements

• Preferably resides in Michigan • Active and unrestricted RN licensure in Michigan • Active and unrestricted Compact Registered Nurse (RN) Licensure in state of residence (MI) • 3+ years of clinical practical experience preferred in areas 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 • Bachelor's Degree in Nursing preferred • Associate's Degree in Nursing required • Direct/hardwired internet connection within 7 feet of 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 provide own workspace furniture • Ability to navigate multiple monitors and applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar Google Workspace • Ability to access secure systems, use VPN/EHR portals, secure devices, manage strong passwords, and identify suspicious emails or links • Ability to troubleshoot common technical issues • Openness to learning new skills

🏖️ Benefits

• 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.) • CVS Health bonus, commission or short-term incentive program eligibility

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