Case Manager, Registered Nurse

This is a fully remote position, open to applicants in Arizona, +11 more states.

📋 Description

• Serve as a liaison among members, clients, families, employers, providers, insurance companies, and healthcare professionals.

• Implement and oversee case management activities for catastrophic cases and chronically ill members across the continuum of care.

• Engage with members and clients both telephonically and in person, which may include visits to homes, workplaces, or physician offices.

• Evaluate and analyze the medical and/or vocational status of injured or chronically ill members and clients.

• Create care plans to assist with condition management, wellness initiatives, medical outcomes, return-to-work strategies, and benefit eligibility.

• Maintain communication with members, clients, and stakeholders, including medical providers, attorneys, employers, and insurance companies.

• Prepare necessary documentation for case work.

• Collaborate with internal multidisciplinary teams.

• Reach out to treating physicians or specialists regarding care and treatment options.

• Provide educational materials and prevention information.

• Apply relevant rehabilitation-service laws, regulations, insurer instructions, and referral-source requirements.

• Assess needs and benefit-plan eligibility utilizing clinical tools and data.

• Monitor progress toward desired outcomes through ongoing assessment and evaluation.

• Develop proactive strategies to enhance both short-term and long-term outcomes as well as overall wellness.

⛳️ Requirements

• Candidate must reside in a state within the Eastern Standard Time Zone (EST).

• Candidate must hold an active and unrestricted Compact Registered Nurse (RN) license in their state of residence.

• A minimum of 2 years of experience in care management is required.

• At least 2 years of experience with Medicare is necessary.

• An Associate’s Degree in Nursing, along with relevant experience in a healthcare-related field, is required.

• Geriatric experience is preferred.

• Experience in a multicultural environment or personal multicultural experience is preferred.

• Certification as a Case Manager is preferred.

• National professional certification (such as CRC, CDMS, CRRN, COHN, or CCM) is preferred.

• A Bachelor’s Degree in Nursing is preferred.

🏝️ Benefits

• Bonus opportunities through CVS Health, including commissions or short-term incentive programs, in addition to base salary.

• Comprehensive medical coverage.

• Dental insurance.

• Vision benefits.

• Paid time off.

• Options for retirement savings.

• Access to wellness programs.

• Additional resources to support physical, emotional, and financial well-being, based on eligibility.