Case Manager, Registered Nurse

Job not on LinkedIn

🔥 15 hours 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: the chance that no one is really hiring for this job.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

• Perform assessment, planning, facilitation, care coordination, evaluation, and advocacy for members’ and families’ comprehensive health needs • Act as a liaison among members/clients/families, employers, providers, insurance companies, and healthcare personnel • Implement and coordinate case management activities for catastrophic cases and chronically ill members/clients across the continuum of care • Coordinate consultant referrals, home care visits, community resources, and alternative levels of care • Interact with members/clients telephonically or in person, including in homes, worksites, or physician offices • Assess and analyze medical and/or vocational status • Develop plans of care to support condition management, wellness, medical outcomes, return to work, optimal functioning, and benefits eligibility • Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers • Prepare required case work documentation • Consult with internal multidisciplinary teams • Conduct outreach to treating physicians or specialists regarding care and treatment • Provide education and prevention information • Apply laws, regulations, insurance-carrier instructions, and referral-source requirements • Evaluate member needs and benefit-plan eligibility using clinical tools and data • Monitor member progress toward desired outcomes through assessment and evaluation • Develop proactive courses of action 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 areas such as 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 • 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 • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure, private, designated home virtual work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide own workspace furniture, such as a desk or standing desk • Ability to use multiple monitors and navigate 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 log in to secure systems such as VPN and EHR portals • Ability to lock computer screens, manage strong passwords, and recognize suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning 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 well-being resources, based on eligibility • Company-provided equipment including keyboard, monitor, computer, and headset

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