Case Manager, Registered Nurse

This is a fully remote position, open to applicants in Arizona, +3 more states.

📋 Description

• Provide thorough case management services via telephonic and/or in-person interactions.

• Evaluate, strategize, implement, and coordinate care plans that cater to members' medical requirements and overall well-being.

• Utilize case management methodologies and service approaches that align with network management and clinical coverage standards.

• Conduct interviews and engage with members to grasp their needs and facilitate their transition to suitable programs and services.

• Employ clinical judgment and data-informed tools to assess member eligibility and identify health risks.

• Create proactive care plans targeting both short-term and long-term health outcomes.

• Perform comprehensive assessments that consider co-morbid conditions, functional limitations, and social determinants of health.

• Review previous claims and assess work capacity.

• Ascertain the necessity for referrals to clinical resources.

• Work collaboratively with supervisors and multidisciplinary teams to address obstacles and enhance care planning.

⛳️ Requirements

• Must hold an active and unrestricted RN license in your state of residence.

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

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

• At least 2 years of Med/Surg experience.

• Availability to work Monday through Friday, from 8:00 AM to 4:30 PM in the local time zone.

• An Associate's Degree in Nursing is required.

• RN License in your state of residence is mandatory.

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer is essential.

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

• WiFi and satellite internet connections are not allowed.

• A quiet, secure, and private designated home virtual workspace that complies with CVS Health and HIPAA regulations is necessary.

• Ability to work within the state and city where currently residing is essential.

• Proficiency in using multiple monitors and navigating various applications simultaneously.

• Competence in communicating through email, calendar invites, Teams messaging, and virtual meetings.

• Familiarity with Microsoft Office 365 applications or equivalent Google Workspace applications is required.

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

• Adherence to computer security protocols, including screen locking, strong password management, and recognizing suspicious emails or links, is necessary.

• Ability to independently troubleshoot common technical issues.

• Willingness to learn new skills as the workplace evolves is essential.

🏝️ Benefits

• Participation in the CVS Health bonus, commission, or short-term incentive program, in addition to base salary.

• Comprehensive medical coverage.

• Dental insurance.

• Vision insurance.

• Paid time off benefits.

• Opportunities for retirement savings.

• Access to wellness programs.

• Provision of company equipment (keyboard, monitor, computer, headset, etc.).

• Company coverage for required additional state licenses.