Case Manager, RN

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🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. • Through the use of clinical tools and information/data review (e.g., assessments, claims, etc..) conducts an evaluation of member’s needs and available benefits to collaborate and refer to programs offered by the plan sponsor. • Applies clinical judgment to reduce risk factors, address complex health issues and social indicators. • Utilizes case management processes in compliance with regulatory and company policies and procedures. • Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

🎯 Requirements

• Must have an active and unrestricted RN license in state of residence, preferably compact • RN living in EST Time Zone • Willingness and ability to obtain additional state licenses upon hire (paid for by the company) • 3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning) • 0-10% travel may be required • Compact RN licensure • 1+ years of case management experience • Certified Case Manager (CCM) certification • Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues. • Experience with all types of Microsoft Office including PowerPoint, Excel, and Word • Strong telephonic communication skills • 1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Additional resources based on eligibility