Case Manager, Registered Nurse – Oncology Experience Required

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🔥 16 hours ago

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• working intensely as a telephonic case manager with patients and their care team • application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, policies, procedures and regulatory standards • assessing benefits and/or member’s needs • applying clinical judgment to the incorporation of strategies designed to reduce risk factors • addressing complex health and social indicators which impact care planning and resolution of member issues • utilizing motivational interviewing skills to ensure maximum member engagement • identifying and escalating member’s needs appropriately following set guidelines and protocols

🎯 Requirements

• 5+ years’ experience as a Registered Nurse, including at least 1 year in a hospital setting • A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC) • 1+ years’ experience documenting electronically using a keyboard • 1+ years’ current or previous experience in Oncology • 1+ years’ Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience • 1+ years' experience in Utilization Review • CCM and/or other URAC recognized accreditation preferred • 1+ years’ experience with MCG, NCCN and/or Lexicomp • Bilingual in Spanish preferred • Bachelors Degree or Associates Degree in Nursing required

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility

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