Case Manager, RN

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

📋 Description

• Perform telephonic evaluations of members’ medical, behavioral, and social requirements

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

• Recognize obstacles to care and execute strategies for risk reduction and member engagement

• Facilitate care coordination among various providers, programs, and community resources

• Analyze clinical data, claims history, and benefit eligibility

• Employ motivational interviewing techniques and clinical judgment to engage members and assist them in achieving their goals

• Collaborate with multidisciplinary teams on intricate cases

• Ensure adherence to regulatory standards and company case management protocols

• Offer care coordination, member advocacy, and support to achieve better health outcomes

⛳️ Requirements

• Current, unrestricted RN license in your state of residence

• Capacity to acquire multi-state/compact licensure

• Over 3 years of clinical nursing experience

• At least 1 year of experience with Microsoft Office (Outlook, Word, Excel)

• Availability to work Monday–Friday with start times as early as 8:00 AM in your local time zone

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

• Preferred compact RN license

• Preferred experience in Case Management

• Preferred Case Manager Certification (CCM or equivalent)

• Preferred BSN

• Required Associate Degree in Nursing

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

• Minimum internet speed of 25 Mbps download and 3 Mbps upload

• Quiet, secure, and private home workspace that complies with CVS Health and HIPAA guidelines

• Must work within the state and city of current residence

• Proficient in using multiple monitors and navigating various applications

• Experience with Microsoft Office 365 applications or similar Google Workspace tools

• Ability to access secure systems such as VPN and EHR portals

• Knowledge of computer, password, and email security practices

• Capability to independently troubleshoot common technical issues

🏝️ Benefits

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

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

• Medical, dental, and vision insurance coverage

• Paid time off

• Retirement savings options

• Wellness programs

• Additional resources supporting physical, emotional, and financial wellness

• Fully remote work arrangement

• No travel required