Case Manager, Registered Nurse – Compact RN License Required

Job not on LinkedIn

🔥 0 minutes ago

🏈 Alabama, Arizona, +5 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🏖️ New Jersey – Remote 🎸 Mississippi – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

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

Upload Resume

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, implement, and coordinate case management activities telephonically and/or face to face • Evaluate members’ medical needs and facilitate overall wellness • Develop proactive courses of action to improve short- and long-term outcomes • Review clinical tools, information, data, benefit plan eligibility, and prior claims • Facilitate 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 • Refer members to clinical resources when needed • Consult with supervisors and colleagues to overcome barriers and meet goals • Present cases at multidisciplinary case conferences • Follow case management processes and regulatory and company policies • Use interviewing skills to engage members and assess health status and needs • Perform blended Case Management and Utilization Management duties for Aetna’s National Medical Excellence team

🎯 Requirements

• Active, current and unrestricted compact Registered Nurse (RN) licensure in the state of residence • 5 years clinical practice experience as a Registered Nurse (RN) • 2+ years’ experience in critical care • 6+ months case management or utilization management experience • Must be able to work Monday–Friday, 8 AM to 5 PM in the time zone of residence • Must be able to obtain multi-state Registered Nurse (RN) licensures • Associate's Degree in Nursing (REQUIRED) • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide own workspace furniture • Experience setting up and using multiple monitors and navigating multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Openness to learning new skills • Preferred: Case Management Certification • Preferred: Transplant experience • Bachelor's Degree in Nursing (PREFERRED)

🏖️ 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 including keyboard, monitor, computer, and headset • Remote work from home