Case Manager, Registered Nurse

This is a fully remote position, open to applicants in Florida, +4 more states.

📋 Description

• Perform thorough assessments of members and gather available clinical data

• Collaborate with members to create personalized care plans that include objectives and interventions

• Deliver education and support for evidence-based disease management

• Coordinate care by engaging relevant interdisciplinary team members

• Ensure seamless healthcare experiences through effective care coordination

• Accurately document care management activities in members' electronic health records in a timely manner

• Work alongside the Interdisciplinary Care Team to overcome barriers to care and sustain stable health conditions

• Recognize and connect members with health plan benefits and community resources

• Comply with regulatory guidelines within designated timelines

• Assist Care Team members with clinical decision-making and provide guidance

• Engage in special projects, process improvement initiatives, and mentor new team members as assigned

• Conduct telephonic member engagement and care coordination for 50–75% of daily activities

⛳️ Requirements

• Current and unrestricted Registered Nurse (RN) license in New York, or compact license in state of residence

• Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams

• Access to a private, dedicated workspace

• Capability to work independently from home while collaborating virtually

• At least 3 years of nursing experience

• Minimum of 2 years of experience in case management, discharge planning, and/or home healthcare coordination

• Experience or willingness to gain in-depth knowledge of care management within Medicare and Medicaid managed care

• Familiarity with community resources and services

• Competent in utilizing healthcare technology tools and maintaining precise records

• Strong verbal and written communication abilities

• Exceptional customer service and member engagement skills

• Capability to meet performance, productivity, call-volume, engagement, and regulatory standards

• Associate’s degree in Nursing (ASN) and relevant healthcare experience required

• Bachelor’s degree in Nursing (BSN) preferred

• Experience with Medicare and/or Medicaid members preferred

• Familiarity with Social Determinants of Health (SDoH) needs, chronic medical conditions, and/or behavioral health preferred

• Experience in conducting health-related assessments and facilitating care planning preferred

• Bilingual skills, particularly in English and Spanish, preferred

🏝️ Benefits

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

• Medical coverage

• Dental coverage

• Vision coverage

• Paid time off

• Retirement savings options

• Wellness programs

• Additional resources supporting physical, emotional, and financial well-being

• Comprehensive benefits package for full-time employees and their families