Case Manager

Job not on LinkedIn

🔥 0 minutes ago

🥔 Idaho – Remote

infoinfo

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

infoinfo
Apply Now
Find Similar Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Logo of CVS Health

CVS Health

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, implement, and coordinate case management activities telephonically and/or face to face • Evaluate members’ medical needs to facilitate overall wellness • Develop proactive courses of action to enhance short- and long-term outcomes • Evaluate member needs and benefit plan eligibility using clinical tools and information/data review • Facilitate integrative functions and transitions to Aetna programs and plans • Apply clinical judgment to reduce risk factors and address complex health and social indicators • Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations • Review prior claims and assess the need for clinical resource referrals • Consult with supervisors and participate in multidisciplinary case conferences • Use case management processes in compliance with regulatory and company policies • Conduct interviews to engage members and determine health status and needs

🎯 Requirements

• Registered Nurse with active and unrestricted RN licensure in their state of residence • Preferably multi-state/compact privileges • Must have the ability to be licensed in all non-compact states • 3+ years clinical practice experience required • Associate's degree required • Compact RN licensure preferred • Case management experience preferred • Case Manager Certification preferred • Experience with Windows / Microsoft Office preferred • Strong computer skills preferred • Bilingual (English/Spanish) speaking preferred

🏖️ 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

Apply Now

Similar Jobs

🔥 7 minutes ago

Turner & Townsend

10,000+ employees

🏗️ Construction

💼 Consulting

🏠 Real Estate

Senior Cost Manager guiding cost planning, controls, and negotiations for Turner & Townsend healthcare construction projects. Supporting clients, contractors, and multidisciplinary teams across complex project lifecycles.

🔥 14 minutes ago

Elevance Health

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Telephonic Nurse Case Manager coordinating care plans for members with complex and chronic needs. Supporting access, authorizations, referrals, and provider collaboration for Elevance Health.

🔥 16 minutes ago

Guardian Life

5001 - 10000

🏥 Healthcare

💼 Consulting

🍽️ Food & Beverage

Appeals Case Manager adjudicating ERISA disability and life insurance claims for Guardian. Investigating disputed claims and delivering compliant appeal determinations.

🔥 19 minutes ago

Einstein Bros Bagels

5001 - 10000

🍽️ Food & Beverage

👥 B2C

Senior Manager managing franchise and license development for Bagel Brands’ breakfast restaurant portfolio. Overseeing candidate pipelines, agreements, renewals, transfers, compliance, vendors, and process improvement.

🔥 21 minutes ago

Cisco

10,000+ employees

🔧 Hardware

🔐 Security

🏢 Enterprise

Strategy and Planning Manager translating Cisco’s enterprise AI strategy into governed, cross-functional execution programs. Building operating cadences, governance frameworks, metrics, and executive reporting.