Case Manager, Registered Nurse

This is a fully remote position, open to applicants in Idaho.

📋 Description

• Provide extensive case management services through telephonic and/or in-person interactions.

• Evaluate, plan, implement, and coordinate care strategies that address members' medical needs and overall well-being.

• Utilize case management protocols and service strategies that align with network management and clinical coverage standards.

• Engage with members through interviews to assess their needs and facilitate transitions to suitable programs and services.

• Leverage clinical judgment and data-driven tools to assess member eligibility and identify health risks.

• Create proactive care plans that focus on both short- and long-term health outcomes.

• Conduct comprehensive assessments of co-morbid conditions, functional limitations, and social determinants impacting health.

• Review past claims and assess work capacity.

• Identify the necessity for referrals to clinical resources.

• Collaborate with supervisors and multidisciplinary teams to address barriers and enhance care planning.

⛳️ Requirements

• Active and unrestricted RN license in the state of residence.

• Willingness and ability to obtain additional state licenses upon hiring.

• A minimum of 3 years of experience in acute care and/or case management.

• At least 2 years of Med/Surg experience.

• Associate's Degree in Nursing.

• Availability to work Monday through Friday, from 8:00 am to 4:30 pm local time zone.

• Minimum internet speed of 25 Mbps download and 3 Mbps upload.

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer; WiFi and satellite internet are not acceptable.

• A quiet, secure, private designated home workspace that complies with CVS Health and HIPAA guidelines.

• Must work within the state and city of current residence.

• Capability to use multiple monitors and navigate through various applications simultaneously.

• Proficient communication skills via email, calendar invites, Teams messaging, and virtual meetings.

• Experience with Microsoft Office 365 applications or comparable Google Workspace applications.

• Ability to access secure systems such as VPN and EHR portals.

• Competence in following computer security practices, including screen locking, creating strong passwords, and identifying suspicious emails or links.

• Ability to troubleshoot common technical issues and reach out to IT when necessary.

🏝️ Benefits

• Company-funded additional state licenses upon hire.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial wellness.

• Company-provided equipment, including keyboard, monitor, computer, and headset.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.