Case Manager, Registered Nurse

Job not on LinkedIn

🔥 14 hours ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $66.6k - $142.6k / 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

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

• 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 with members/clients/families, employers, providers, insurance companies, and healthcare personnel • Implement and 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 potentially in homes, worksites, or physician offices • Assess injured, acute, or chronically ill members’/clients’ medical and vocational status • Develop plans of care to optimize wellness, medical outcomes, return to work, and functional outcomes • Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers • Prepare required documentation of case work activities • Consult with internal multidisciplinary teams • Contact treating physicians or specialists regarding courses of care and treatment • Provide education and prevention information • Apply laws, regulations, insurance-carrier instructions, and referral-source requirements • Evaluate needs and benefit-plan eligibility using clinical tools and data • Monitor progress toward desired outcomes through assessment and evaluation • Develop proactive actions to improve short- and long-term outcomes and overall wellness

🎯 Requirements

• Candidate preferably resides in MA • Active and unrestricted RN licensure in MA • 3+ years of clinical practical experience preferred, 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 and use 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 • Excellent analytical and problem-solving skills preferred • Effective communication, organizational, and interpersonal skills preferred • Bilingual Spanish preferred • Associate's Degree in Nursing required • Bachelor's Degree in Nursing preferred • Active and unrestricted Compact Registered Nurse (RN) Licensure in the state of residence (MA) • Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum 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 • Must be able to use multiple monitors and applications simultaneously • Ability to communicate via 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, secure devices, manage strong passwords, and recognize suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills as the workplace evolves

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to the base pay range • 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.)

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