Case Manager – Registered Nurse

Job not on LinkedIn

🔥 13 hours ago

🏈 Alabama, Florida, +8 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🎸 Mississippi – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote ⚔️ Virginia – 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, 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, insurers, attorneys, and healthcare personnel • Implement and coordinate case management activities for catastrophic cases and chronically ill members/clients across the continuum of care • Conduct consultant referrals, home care visits, use of 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 and implement plans of care to optimize wellness, medical outcomes, return to work, and functioning • Communicate with members/clients and stakeholders regarding care and treatment • Prepare required case work documentation • Consult with internal multidisciplinary teams • Outreach to treating physicians or specialists regarding care and treatment • Provide education and prevention information • Apply rehabilitation-service laws, regulations, insurer instructions, and referral-source requirements • Testify as required to substantiate case work or reports • Evaluate needs and benefit-plan eligibility using clinical tools and data • Use compliant case management processes under regulatory and company policies • Develop proactive courses of action to improve short- and long-term outcomes • Monitor member/client progress toward desired outcomes through assessment and evaluation

🎯 Requirements

• Candidate must reside in the South Region: OH, VA, NC, KY, TN, SC, GA, AL, MS, AR, LA, FL • Active and unrestricted Compact Registered Nurse (RN) Licensure in OH or in their state of residence • 3+ years clinical practical experience preference: diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac with Medicare members • 2+ years case management, discharge planning and/or home health care coordination experience • Associate's Degree or Nursing Diploma (REQUIRED) • Bachelor's Degree (PREFERRED) • Bilingual - Spanish • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills • Ability to work independently • Proficiency with MS Word, Excel, Outlook, PowerPoint, and proprietary applications • Efficient computer skills, including navigating multiple systems and keyboarding • Certified Case Manager • National professional certification (CRC, CDMS, CRRN, COHN, or CCM) • Must have or be able to obtain a direct/hardwired internet connection with minimum 25 Mbps download and 3 Mbps upload; WiFi and satellite internet are not permitted • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to set up and use multiple monitors and navigate multiple applications • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar applications • Ability to log in to secure systems, use VPN/EHR portals, secure computer screens, manage strong passwords, and recognize suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills • If hired, commitment to obtaining required internet speeds and adhering 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.)