Case Manager, RN

Job not on LinkedIn

🔥 12 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 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

• Assess, plan, implement, and coordinate case management activities with members telephonically and/or face to face • Evaluate members’ medical needs to facilitate overall wellness • Develop proactive courses of action to improve short- and long-term outcomes • Review clinical tools, information, data, benefit plan eligibility, and prior claims • Facilitate integrative functions and transitions to Aetna programs and plans • Apply clinical judgment to reduce risk factors and address complex health and social indicators • Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations • Refer members to clinical resources when needed • Consult with supervisors and participate in multidisciplinary case conferences • Follow regulatory and company case management policies and procedures • Use interviewing skills to engage members and determine health status and needs

🎯 Requirements

• Active, current and unrestricted RN licensure in the state of residence • Multiple State RN licensure welcomed but not required; willingness and ability to obtain multiple state RN licensure after hire if chosen • 2+ years of clinical experience as an RN • 3+ years’ experience with Microsoft Office Suite • Willingness and ability to work Monday through Friday, 9:00am–5:30pm EST • Willingness and ability to work occasional evening, weekend, and holiday shifts as needed • Associates Degree required • Certified Case Manager (CCM) certification preferred • Case Management in an integrated model preferred • Discharge Planning experience preferred • Managed care experience preferred

🏖️ 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-paid expenses for obtaining multiple state RN licensure after hire, if chosen

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