Case Manager, Registered Nurse

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🔥 0 minutes ago

🏈 Alabama, Florida, +6 more states – Remote

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💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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Logo of CVS Health

CVS Health

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 options and services addressing members’ and families’ comprehensive health needs • Act as 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 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 • Meet with members/clients in homes, worksites, or physician offices as required • Assess and analyze medical and/or vocational status • Develop plans of care to support condition management, wellness, medical outcomes, return to work, and optimal functioning • Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers • Prepare required documentation of case work activities • Consult with internal multidisciplinary teams • Contact treating physicians or specialists regarding care and treatment • Provide education and prevention information • Apply applicable laws, regulations, and insurer/referral-source instructions • Evaluate needs and benefit-plan eligibility using clinical tools and data • Monitor progress toward desired outcomes through assessment and evaluation • Develop proactive courses of action and enhance short- and long-term outcomes

🎯 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) • Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals • Ability to lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links • Ability to resolve common technical issues independently • 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 • Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide or obtain required internet speeds and adhere to Work From Home requirements

🏖️ 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.)

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