Case Manager Registered Nurse

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

This RN Case Manager position is 100% remote and candidates can apply from any state but must work the stated hours.

There is a preference for nurses in a compact RN licensure state, however, that is not required.

Normal Working Hours: Monday through Friday between the hours of 8:30am – 5:00pm in their time zone for a scheduled 8-hour shift.

Weekends and holidays may be required per the needs of the department. Currently, both weekends and holidays are on-call only and covered on a volunteer basis.

Less than 5% travel may be required for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., finger printing.

The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.

RN Case Manager

– Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.

– Through the use of clinical tools and information/data review (e.g., assessments, claims, etc.) conducts an evaluation of member’s needs and available benefits to collaborate and refer to programs offered by the plan sponsor.

– Applies clinical judgment to reduce risk factors, address complex health issues and social indicators.

– Utilizes case management processes in compliance with regulatory and company policies and procedures.

– Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Required Qualifications

• Must have an active current and unrestricted RN license in state of residence. If located within the Nurse Licensure Compact jurisdiction, the ability to use their compact license without restriction.
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company).
• 3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning).
• Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time.
• A private designated workspace free of distractions and high-speed internet.

Preferred Qualifications

• Compact RN licensure
• 1+ years of case management experience
• Certified Case Manager (CCM) certification
• Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.
• Experience with all types of Microsoft Office including PowerPoint, Excel, and Word
• Strong telephonic communication skills
• 1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.

Education

• Associates Degree in Nursing required.
• Bachelor's in Science & Nursing preferred.

Work from Home Requirements

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and