Case Manager, RN

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

📋 Description

• Conduct telephonic evaluations to assess the medical, behavioral, and social needs of members.

• Create personalized care plans aimed at enhancing health outcomes and overall wellness.

• Identify obstacles to care and implement strategies to mitigate risks and boost engagement.

• Coordinate care among providers, programs, and community resources.

• Review clinical data, claims history, and benefit eligibility to assist in interventions.

• Employ motivational interviewing techniques and clinical judgment to connect with members and facilitate goal attainment.

• Collaborate with multidisciplinary teams on intricate cases.

• Promote optimal outcomes for members.

• Ensure adherence to regulatory standards and company case management protocols.

• Provide case management coverage from Monday to Friday, with rotating late shifts and holiday on-call support as required.

⛳️ Requirements

• Active, unrestricted RN license in your state of residence.

• Capability to obtain multi-state/compact licensure (company-sponsored).

• Over 3 years of clinical nursing experience.

• At least 1 year of experience with Microsoft Office applications, including Outlook, Word, and Excel.

• Availability to work Monday to Friday, with shifts commencing as early as 8:00 AM local time.

• Willingness to participate in rotating late shifts until 8:00 PM EST and holiday on-call coverage as necessary.

• Compact RN license is preferred.

• Experience in Case Management is preferred.

• Case Manager Certification (CCM or equivalent) is preferred.

• BSN is preferred.

• An Associate Degree in Nursing is required.

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

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

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

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

• Ability to set up and utilize multiple monitors and navigate various applications.

• Familiarity with Microsoft Office 365 applications or similar Google Workspace tools is needed.

• Proficiency in using secure systems such as VPN and EHR portals.

• Adherence to computer security practices, management of strong passwords, and ability to recognize suspicious emails or links is required.

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

• Willingness to learn new workplace skills.

🏝️ Benefits

• Company-sponsored opportunity to obtain multi-state/compact licensure.

• Company-supported multi-state licensure options.

• No travel obligations.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings plans.

• Wellness initiatives.

• Additional resources aimed at supporting colleagues’ physical, emotional, and financial wellness.

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

• A supportive atmosphere with an experienced interdisciplinary team.

• Opportunities to enhance case management expertise.