Case Manager, Registered Nurse
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Job Description
Remote RN Case Manager coordinating CVS Health members’ clinical care, benefits, and wellness. Assessing needs and managing care through telephonic and face-to-face member engagement.
Responsibilities:
- Assess, plan, implement, and coordinate case management activities telephonically and/or face to face
- Evaluate members’ medical needs to facilitate overall wellness
- Collaboratively develop proactive courses of action to improve short- and long-term outcomes
- Review assessments, claims, clinical tools, information, and available benefits
- Collaborate with and refer members to programs offered by the plan sponsor
- Apply clinical judgment to reduce risk factors and address complex health issues and social indicators
- Use case management processes in compliance with regulatory and company policies and procedures
- Interview members to maximize engagement and determine health status and needs
- Work Monday through Friday during scheduled 8-hour shifts between 8:30 a.m. and 5:00 p.m. local time
- Potentially provide weekend and holiday on-call coverage on a volunteer basis
- Travel less than 5% for on-site meetings, trainings, system updates, or licensure requirements
Requirements:
- Active, current, and unrestricted RN license in the state of residence
- Ability to use a compact RN license without restriction if located within the Nurse Licensure Compact jurisdiction
- Willingness and ability to obtain additional state licenses upon hire
- 3+ years of acute care clinical experience as an RN
- Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods
- Private designated workspace free of distractions and high-speed internet
- Associates Degree in Nursing required
- Direct/hardwired internet connection to a modem/router within 7 feet of the computer
- Minimum internet speed of 25 Mbps download and 3 Mbps upload
- Quiet, secure, private home workspace compliant with CVS Health and HIPAA guidelines
- Ability to work within the state and city where currently residing
- Microsoft Office 365 or similar Google Workspace experience
- Ability to use email, calendar invites, Teams messaging, and virtual meetings
- Ability to access secure systems such as VPN and EHR portals
- Ability to manage strong passwords and recognize suspicious emails or links
- Ability to troubleshoot common technical issues and contact IT when needed
- Preferred: Compact RN licensure
- Preferred: 1+ years of case management experience
- Preferred: Certified Case Manager (CCM) certification
- Preferred: Experience with Microsoft PowerPoint, Excel, and Word
- Preferred: Strong telephonic communication skills
- Preferred: 1+ years of experience using computers and multiple monitors while speaking by telephone
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 including keyboard, monitor, computer, and headset
- Additional state licenses paid for by the company
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