Case Manager, Registered Nurse

Job not on LinkedIn

🔥 0 minutes ago

🏈 Alabama, Florida, +7 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote 🐎 Kentucky – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🎸 Mississippi – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote ⚔️ Virginia – Remote

💵 $54.1k - $116.8k / 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

• Facilitate delivery of benefits and healthcare information determining benefit eligibility • Promote wellness activities and support Health Strategies, policies, and programs • Conduct assessment, planning, facilitation, care coordination, evaluation, and advocacy for members and families • Act as liaison among members, families, employers, providers, insurers, and healthcare personnel • Coordinate case management for catastrophic cases and chronically ill members across the continuum of care • Coordinate consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members by telephone or in person, including at homes, worksites, or physician offices • Assess medical and vocational status and develop individualized plans of care • Communicate with providers, attorneys, employers, insurance carriers, and other stakeholders • Prepare required case-work documentation • Consult with internal multidisciplinary teams and treating physicians or specialists • Provide education and prevention information • Apply laws, regulations, insurer instructions, and referral-source requirements • Evaluate member needs and benefit-plan eligibility using clinical tools and data • Monitor progress toward desired outcomes and optimize wellness, medical outcomes, function, and return to work • Develop proactive courses of action to improve short- and long-term outcomes

🎯 Requirements

• Candidates must reside in the Southeast Region: FL, GA, AL, MS, NC, SC, TN, OH, AK, KY, VA • Active and unrestricted Compact Registered Nurse (RN) license and residence in a compact state • 3+ years clinical practical experience, preferably in diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, or home health with Medicare members • 2+ years case management, discharge planning and/or home health care coordination experience • Dependents must have separate care arrangements during work hours • Access to a private, dedicated workspace • Excellent analytical and problem-solving skills • Effective communication, organizational, and interpersonal skills • Ability to work independently • Certified Case Manager preferred • National professional certification such as CRC, CDMS, CRRN, COHN, or CCM preferred • Efficient computer skills, including navigating multiple systems and keyboarding • Willingness and ability to obtain multi-state RN licenses if needed • Associate's Degree in Nursing required • Bachelor's Degree in Nursing preferred • Direct/hardwired internet connection within 7 feet of the modem/router, with minimum 25 Mbps download and 3 Mbps upload; WiFi and satellite internet are not permitted • Quiet, secure, private home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently residing • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to use VPN and EHR portals, secure systems, strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Ability to learn 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-provided equipment (keyboard, monitor, computer, headset, etc.) • Company-provided multi-state RN licenses if needed