Case Manager, Registered Nurse – Medicare

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

📋 Description

• Facilitate the provision of relevant benefits and healthcare information to assess benefit eligibility.

• Encourage participation in wellness initiatives.

• Design, implement, and support health strategies, policies, and programs.

• Ensure the distribution of benefits while promoting member wellness and a timely return to work.

• Perform assessment, planning, facilitation, care coordination, evaluation, and advocacy.

• Coordinate options and services that address the comprehensive health needs of individuals and families.

• Collaborate effectively with members, providers, and community organizations.

• Address the healthcare and social determinant needs of members.

• Promote quality outcomes that are cost-effective.

• Serve Community Care members through a member-focused, team-based, community-oriented care management model.

⛳️ Requirements

• Active and unrestricted RN Compact license is required.

• A minimum of 3+ years of clinical practical experience is preferred, including experience with Medicare members; preferred conditions include Diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac care.

• At least 2+ years of experience in Case Management, discharge planning, and/or home health care coordination.

• Strong analytical and problem-solving skills are essential.

• Excellent communication, organizational, and interpersonal skills are required.

• Ability to work independently, which may include working from home.

• Proficiency in MS Word, Excel, Outlook, PowerPoint, and proprietary applications is necessary.

• Competent computer skills, including navigating multiple systems and keyboarding.

• Willingness and capability to obtain multi-state RN licenses if necessary.

• Certification as a Case Manager is preferred.

• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred but not mandatory.

• An Associate degree or Nursing diploma is required.

• A Bachelor's degree is preferred.

• Availability to work Monday-Friday, 8:00 am - 5:00 pm Eastern Time.

🏝️ Benefits

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

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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

• The company will provide multi-state RN licenses if required.