Case Manager, Registered Nurse

Job not on LinkedIn

🔥 49 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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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

• Develop proactive courses of action to address member issues and improve short- and long-term outcomes • Enhance members’ overall wellness through integrated care • 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 barriers and address complex health and social indicators • Conduct holistic assessments covering co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations • Review prior claims for potential impact on case management and eligibility • Assess need for referrals to clinical resources • Consult with supervisors and others to overcome barriers and meet goals and objectives • Present cases at multidisciplinary case conferences • Use case management processes in compliance with regulatory and company policies and procedures • Conduct interviews to engage members and determine health status and needs • Work remotely from home Monday through Friday, generally 9:00am–5:30pm in the resident’s time zone, with occasional late-shift rotation until 8:00pm EST • Flex an 8-hour shift between 8:00am and 6:00pm • No weekends, holiday shifts, or travel currently required

🎯 Requirements

• Active Illinois RN licensure required; candidate does not need to live in Illinois • 2+ years of clinical experience as an RN • Associate’s degree in nursing minimum required • Ability to work 40 hours per week • 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 workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide workspace furniture, such as a desk or standing desk • Ability to use multiple monitors and navigate multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer security practices, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Preferred: 1+ years of case management experience • Preferred: Compact RN licensure or willingness and ability to obtain multiple state RN licensure after hire • Preferred: Certified Case Manager (CCM) certification • Preferred: Strong telephonic communication skills

🏖️ 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 (keyboard, monitor, computer, headset, etc.) • Expenses paid by company for obtaining multiple state RN licensure after hire

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