Case Manager, Registered Nurse – Medicare
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Job Description
Remote Medicare Case Manager RN coordinating comprehensive member care, benefits, and wellness for CVS Health. Collaborating with members, providers, and community organizations to improve outcomes.
Responsibilities:
- Facilitate delivery of appropriate benefits and healthcare information to determine benefit eligibility
- Promote wellness activities
- Develop, implement, and support health strategies, tactics, policies, and programs
- Conduct assessment, planning, facilitation, care coordination, evaluation, and advocacy for members’ comprehensive health needs
- Collaborate with members, providers, and community organizations
- Address members’ healthcare and social determinant needs
- Promote quality, cost-effective outcomes
- Support successful and timely return to work
Requirements:
- Active and unrestricted RN Compact licensure
- Minimum 3+ years clinical practical experience preference with Medicare members, including diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac experience
- Minimum 2+ years Case Management, discharge planning and/or home health care coordination experience
- 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
- Willingness and ability to obtain multi-state RN licenses if needed
- Associate degree or Nursing diploma required
Benefits:
- CVS Health bonus, commission or short-term incentive program in addition to base pay range
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being, based on eligibility
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