Case Manager, RN

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

📋 Description

• Conduct assessments, planning, implementation, and coordination of case management activities through telephone or face-to-face interactions.

• Assess members’ medical requirements to promote overall wellness.

• Collaboratively establish proactive action plans aimed at enhancing both short- and long-term health outcomes.

• Review clinical resources and data, including assessments and claims.

• Analyze member needs alongside available benefits.

• Collaborate with and refer members to programs provided by the plan sponsor.

• Utilize clinical judgment to mitigate risk factors and address intricate health concerns and social determinants.

• Implement case management procedures in alignment with regulatory standards and company policies.

• Conduct interviews to optimize member engagement and evaluate health status and needs.

• Work from Monday to Friday, 8am–5pm in the resident time zone, with flexibility to accommodate member and business requirements.

⛳️ Requirements

• Possession of an active and unrestricted RN license in the state of residence, preferably compact.

• RN residing in the Eastern Standard Time (EST) Zone.

• Willingness and capability to acquire additional state licenses upon employment.

• Minimum of 3 years of acute care clinical experience as an RN.

• Travel of 0–10% may be necessary.

• An associate degree in nursing or a Bachelor of Science in Nursing (BSN).

• A private designated workspace that is free from distractions.

• Access to high-speed internet.

• Proficient in using a computer workstation with multiple screens and operating several programs simultaneously.

• Capability to sit for extended periods.

• Preference for candidates with at least 1 year of case management experience.

• Certified Case Manager (CCM) certification is preferred.

• Strong customer service skills are preferred.

• Familiarity with Microsoft Office applications, including PowerPoint, Excel, and Word is preferred.

• Excellent telephonic communication skills are preferred.

• At least 1 year of experience using computers and managing multiple monitors while engaging in telephone conversations is preferred.

• Transgender certification is preferred.

🏝️ Benefits

• CVS Health bonus, commission or short-term incentive program.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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

• Company-paid acquisition of additional state licenses upon hire.