Case Manager, Registered Nurse

Job not on LinkedIn

🕒 August 25

🗽 New York – Remote

🗽 New York – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 25%

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

• Provide comprehensive care management services to members with complex medical, behavioral health, and social needs • Conduct clinical assessments and identify member needs • Develop and monitor person-centered care plans • Coordinate care across providers and community resources • Facilitate transitions of care • Identify and address barriers to health outcomes • Ensure members receive medically necessary and cost-effective services • Collaborate with interdisciplinary teams, members, caregivers, and providers • Promote quality outcomes, member satisfaction, regulatory compliance, and organizational goals • Communicate through email, calendar invites, Teams messaging, and virtual meetings • Navigate multiple monitors and applications to streamline tasks and improve efficiency • Log in to secure systems and maintain workplace security • Troubleshoot common technical issues and contact IT for unresolved issues

🎯 Requirements

• Active and unrestricted Registered Nurse (RN) license in the applicable state • Minimum of 3 to 5 years of clinical nursing experience, preferably in care management, case management, home care, long-term care, managed care, utilization management, or community-based healthcare settings • Experience coordinating care for members with complex medical, behavioral health, and psychosocial needs • Strong knowledge of chronic disease management, care coordination, and healthcare delivery systems • Ability to perform clinical assessments, identify member needs, and develop comprehensive care plans • Excellent communication, organizational, critical thinking, and problem-solving skills • Proficiency in Microsoft Office applications and electronic documentation systems • Ability to work independently while effectively collaborating with interdisciplinary teams • Certified Case Manager (CCM) certification or willingness to obtain certification • Experience working in Managed Long-Term Care (MLTC), Medicare, Medicaid, Dual Eligible, or other managed care populations • Knowledge and experience with the Uniform Assessment System (UAS-NY) and person-centered service planning • Experience coordinating home and community-based services (HCBS), long-term services and supports (LTSS), and behavioral health services • Bilingual skills preferred • Experience working in a remote or field-based care management environment • Bachelor's Degree in Nursing (BSN) preferred • Current, unrestricted Registered Nurse (RN) license required • Additional certifications in Case Management, Care Coordination, Utilization Management, or related specialties are preferred • Direct/hardwired internet connection to a modem/router within 7 feet of the computer, or ability to obtain one • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Own workspace furniture, such as a desk or standing desk • Proficiency with multiple monitors and multiple applications • Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) or similar Google Workspace applications • 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 and contact IT when needed • Openness to learning new skills

🏖️ 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 • Company-provided equipment (keyboard, monitor, computer, headset, etc.)