Case Manager, RN

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🔥 0 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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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

• Conduct telephonic assessments to evaluate members’ medical, behavioral, and social needs • Develop individualized care plans supporting improved health outcomes and wellness • Identify barriers to care and implement strategies to reduce risk and improve engagement • Coordinate care across providers, programs, and community resources • Review clinical information, claims history, and benefit eligibility to support interventions • Use motivational interviewing and clinical judgment to engage members and support goal achievement • Collaborate with multidisciplinary teams on complex cases • Facilitate optimal member outcomes • Ensure compliance with regulatory requirements and company case management standards • Provide Monday–Friday case management coverage, with rotating late shifts and holiday on-call support as needed

🎯 Requirements

• Active, unrestricted RN license in your state of residence • Ability to obtain multi-state/compact licensure (company-paid) • 3+ years of clinical nursing experience • At least 1 year of experience using Microsoft Office, including Outlook, Word, and Excel • Ability to work Monday–Friday with schedules starting as early as 8:00 AM local time • Ability to participate in rotating late shifts up to 8:00 PM EST and holiday on-call coverage as needed • Compact RN license preferred • Case Management experience preferred • Case Manager Certification (CCM or equivalent) preferred • BSN preferred • Associate Degree in Nursing required • Direct/hardwired internet connection to modem/router within 7 feet of computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently residing • Ability to set up and use multiple monitors and navigate multiple applications • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to use secure systems such as VPN and EHR portals • Ability to follow computer security practices, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues and contact IT when needed • Openness to learning new workplace skills

🏖️ Benefits

• Company-paid opportunity to obtain multi-state/compact licensure • Company-sponsored multi-state licensure opportunities • No travel requirements • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting colleagues’ physical, emotional, and financial well-being • Company-provided equipment including keyboard, monitor, computer, and headset • Supportive environment and experienced interdisciplinary team • Opportunities to expand case management expertise