Case Manager, Registered Nurse

Job not on LinkedIn

🔥 9 minutes ago

🏈 Alabama, North Carolina, +5 more states – Remote

🏈 Alabama – Remote 🌲 North Carolina – Remote 🦀 Maryland – Remote 🎸 Mississippi – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote ⚔️ Virginia – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 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, plan, facilitate, coordinate, evaluate, and advocate for services addressing members’ and families’ comprehensive health needs • Act as a liaison among members, clients, families, employers, providers, insurers, and healthcare personnel • Coordinate case management activities for catastrophic cases and chronically ill members across the continuum of care • Arrange consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members by telephone or in person, including possible visits to homes, worksites, or physician offices • Assess medical and vocational status and develop care plans to optimize wellness, medical outcomes, functioning, benefits eligibility, and return to work • Communicate with medical providers, attorneys, employers, and insurance carriers • Prepare required case-work documentation • Consult with internal multidisciplinary teams • Contact treating physicians or specialists regarding care and treatment • Provide education and prevention information • Apply rehabilitation-service laws, regulations, insurer 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

• Active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida • 3+ years of clinical practical experience preferred in 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 • Associate's Degree in Nursing or Nursing Diploma required • Bachelor's Degree in Nursing preferred • Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload; WiFi and satellite internet are not permitted • Quiet, secure, private, distraction-free home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to obtain required internet speeds and comply with Work From Home requirements • Ability to set up and use multiple monitors and navigate multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals, maintain password security, and identify suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills • Spanish bilingual ability, Certified Case Manager credential, and national professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred

🏖️ 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 eligibility • Company-provided equipment including keyboard, monitor, computer, and headset