Case Manager, Registered Nurse

Job not on LinkedIn

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 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.

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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

• Facilitate delivery of appropriate benefits and healthcare information • Develop, implement, and support health strategies, tactics, policies, and programs • Assess, plan, facilitate, coordinate, evaluate, and advocate for individual and family health needs • Act as liaison among members, families, employers, providers, insurers, and healthcare personnel • Coordinate case management activities for catastrophic cases and chronically ill members across the continuum of care • Provide consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members telephonically or in person, including in homes, worksites, or physician offices • Assess medical and vocational status and develop plans of care • Communicate with members 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 care and treatment • Provide education and prevention information • Apply 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 progress toward desired outcomes through assessment and evaluation • Facilitate condition management, wellness, medical outcomes, return to baseline, optimal function, or return to work

🎯 Requirements

• Must reside in Florida • Active and unrestricted Compact Registered Nurse (RN) License in Florida • 3+ years clinical practical experience preferred in diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac with Medicare members • 2+ years case management, discharge planning and/or home health care coordination experience • Associate's Degree in Nursing with equivalent experience or Nursing Diploma (REQUIRED) • Bachelor's Degree (PREFERRED) • Ability to occasionally travel within a designated geographic area for in-person case management activities • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills • Ability to work independently • Proficiency with MS Word, Excel, Outlook, PowerPoint, and proprietary applications • Efficient computer skills, including navigating multiple systems and keyboarding • Certified Case Manager preferred • Additional national professional certification such as CRC, CDMS, CRRN, COHN, or CCM • Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Ability to use multiple monitors and navigate multiple applications • Experience with Microsoft Office 365 or similar applications • Ability to access secure systems such as VPN and EHR portals • Ability to resolve common technical issues independently • Openness to learning new skills • Must work within the state and city where currently residing

🏖️ 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, headset, etc.