Case Manager, Registered Nurse – NICU, Maternity, Women's Health

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🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $54.1k - $142.6k / 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.

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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

• Telephonically and/or face to face assess, plan, implement, and coordinate case management activities • Evaluate members' medical needs within a NICU/high-risk maternity case management program • Facilitate members' overall wellness and manage all aspects of their NICU and/or maternity journey • Develop proactive courses of action to address issues and improve short- and long-term outcomes • Evaluate member needs, benefit plan eligibility, and transitions to Aetna programs and plans using clinical tools and data review • Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators • Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations • Review prior claims for potential impact on case management and eligibility • Refer members to clinical resources when needed • Consult with supervisors and colleagues to overcome barriers and present cases at multidisciplinary case conferences • Use case management processes in compliance with regulatory and company policies • Conduct interviews to maximize member engagement and determine health status and needs

🎯 Requirements

• Must hold an active and unrestricted RN License • Must be willing and able to pursue multi-state licensure • Minimum of 3+ years of clinical experience as an RN in a NICU setting • Preferred RN licensure in a compact state • Clinical experience as an RN in an inpatient or outpatient setting focused on women's health, Infertility, maternity and/or OB-GYN office setting • 1+ years of Case Management experience in an integrated model • 1+ years of experience with Telephonic Case Management • Experience with Microsoft Office, including PowerPoint, Excel, and Word • Certified Case Manager (CCM) certification • Experience with ATV/ASD • Associates Degree Nursing • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 mbs download and 3 mbs upload • Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines • Ability to work within the state and city where currently living • Ability to use multiple monitors and navigate multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar (Google Workspace) • Ability to access secure systems such as VPN and EHR portals, maintain 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 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-paid multi-state licensure • Company-provided equipment (keyboard, monitor, computer, headset, etc.)