Case Manager, Registered Nurse

Job not on LinkedIn

🔥 15 minutes ago

🏈 Alabama, Arizona, +39 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $60.5k - $129.6k / 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, implement, and coordinate case management activities telephonically and/or face to face • Evaluate members’ medical needs to facilitate overall wellness • Develop proactive courses of action to improve short- and long-term outcomes • Review clinical tools and information/data to evaluate member needs and benefit plan eligibility • Facilitate integration and transitions to Aetna programs and plans • Apply clinical judgment to reduce risk factors and address complex health and social indicators • Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations • Review prior claims and their potential impact on case management and eligibility • Determine need for referrals to clinical resources • Consult with supervisors and others to overcome barriers • Present cases at multidisciplinary case conferences • Use case management processes in compliance with regulatory and company policies • Conduct interviews to engage members and determine health status and needs

🎯 Requirements

• Active RN licensure in the state where you reside • 2+ years of clinical experience as an RN • Multiple state RN licensure welcomed but not required; if chosen, willingness and ability to obtain it after hire • Associates Degree in Nursing • Ability to work Monday through Friday, 9:00am–5:30pm in the time zone of residence • Availability for occasional evening, weekend, and holiday shifts • 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 • WiFi and satellite internet are not permitted • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Ability to work within the state and city where currently residing • Ability to provide own workspace furniture • Ability to use multiple monitors and navigate multiple applications • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Ability to log in to secure systems such as VPN and EHR portals • Ability to follow computer security practices, including strong passwords and recognizing suspicious emails or links • Ability to troubleshoot common technical issues • Preferred: Certified Case Manager (CCM) certification • Preferred: residence in a compact state • Preferred: 3+ years’ experience with Microsoft Office Suite • Preferred: case management in an integrated model • Preferred: discharge planning experience • Preferred: managed care experience • Preferred: BSN

🏖️ 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 (keyboard, monitor, computer, headset, etc.) • Company-paid expenses for obtaining multiple state RN licensure after hire