Case Manager, Registered Nurse

Job not on LinkedIn

🔥 13 hours ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $60.5k - $129.6k / 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

• Assess members telephonically and/or face to face • Plan, implement, and coordinate case management activities • Evaluate members’ medical needs to facilitate overall wellness • Collaboratively develop proactive courses of action to improve short- and long-term outcomes • Review clinical tools, assessments, claims, and other data to evaluate member needs and available benefits • Collaborate with and refer members to programs offered by plan sponsors • Apply clinical judgment to reduce risk factors and address complex health issues and social indicators • Use case management processes in compliance with regulatory and company policies and procedures • Use interviewing skills to maximize member engagement and determine health status and needs • Work Monday through Friday during scheduled 8-hour shifts between 8:30 a.m. and 5:00 p.m. in the employee’s time zone • Potentially work weekends and holidays on an on-call, volunteer basis • Travel less than 5% for on-site meetings, training, system updates, or licensure requirements

🎯 Requirements

• Active, current, and unrestricted RN license in the state of residence • Ability to use a compact RN license without restriction if located within the Nurse Licensure Compact jurisdiction • Willingness and ability to obtain additional state licenses upon hire • 3+ years of acute care clinical experience as an RN • Ability to use a computer station with multiple screens and operate multiple programs simultaneously • Ability to sit for extended periods of time • Private designated workspace free of distractions • High-speed internet • Associate Degree in Nursing required • 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 • Quiet, secure, private, and HIPAA-compliant home workspace • Ability to work within the state and city where currently living • Experience with multiple monitors and multiple applications • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar tools such as Google Workspace • 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 resolve common technical issues independently • Preferred: Compact RN licensure • Preferred: 1+ years of case management experience • Preferred: Certified Case Manager (CCM) certification • Preferred: Experience with Microsoft PowerPoint, Excel, and Word • Preferred: Strong telephonic communication skills • Preferred: 1+ years of experience using computers and navigating multiple monitors while speaking on the telephone

🏖️ 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 including keyboard, monitor, computer, and headset • Additional state licenses paid for by the company