Case Manager, RN

Job not on LinkedIn

🕒 August 27

🏈 Ohio – Remote

infoinfo

💵 $54.1k - $129.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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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

• Apply data-driven methods to identify members for individualized case management programs or alternative healthcare referrals • Conduct comprehensive clinical assessments • Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services • Advocate for patients to the full extent of existing healthcare coverage • Promote quality, cost-effective outcomes and suggest improvements to program/operational efficiency • Identify and escalate quality-of-care issues through established channels • Provide a very high level of customer service • Assess members’ health literacy, technology capabilities and readiness to change • Use influencing and motivational interviewing skills to maximize member engagement and promote lifestyle/behavior changes • Provide coaching, information, education and support for independent medical and healthy lifestyle choices • Coordinate assessment, planning, facilitation and advocacy for member benefit and health needs • Perform inpatient review and discharge planning • Develop, implement, monitor and evaluate case management plans • Involve the Medical Director as indicated and close cases when discharge criteria are met

🎯 Requirements

• Active, current and unrestricted RN license in state of residence • Willingness and ability to obtain additional state licenses upon hire • 3+ years of acute care experience as an RN • Willingness to work Monday through Friday 8:00am through 4:30pm in time zone of residence, with an occasional late shift rotation 11:00 AM-8:00 PM EST once per quarter • Associate Degree required • Compact RN License or Multi state licensure preferred • Certified Case Manager (CCM) preferred • Managed Care experience preferred • Hospital experience in ICU, CCU, Step Down, ER or OR preferred • Telephonic case management and/or telephonic experience preferred • Direct/hardwired internet connection to a modem/router within 7 feet of computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • WiFi and satellite internet are not permitted • Quiet, secure and 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 • Experience or ability to use multiple monitors and 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, secure devices and recognize suspicious emails or links • Ability to resolve common technical issues independently and contact IT when needed • Openness to learning new workplace skills

🏖️ 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.) • Additional state licenses paid for by the company

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