CVS Health

Bringing our heart to every moment of your health.

Case Manager, RN

ManagerManagerFull TimeRemoteTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

North Carolina

Posted

38 days ago

Salary

$54.1K - $142.6K / year

Associate Degree2 yrs expEnglish

Job Description

• 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 the member’s overall wellness • 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 • Conducts an evaluation of member’s needs and benefit plan eligibility • Facilitates integrative functions as well as smooth transition to Aetna programs and plans • Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers • Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality • Reviews prior claims to address potential impact on current case management and eligibility • Assessments include the member’s level of work capacity and related restrictions/limitations • Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Job Requirements

  • Must have an active and unrestricted RN license in the state that you reside
  • Multiple State RN licensure is welcomed but not required
  • 2 + years of clinical experience as an RN
  • All clinical experience will be considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical / Surgical, Orthopedics, Long Term Care, and Infusion nursing
  • 2 + years’ experience with Telephonic Case Management (preferred)
  • 1+ years’ experience with all types of Microsoft Office including PowerPoint, Excel, and Word
  • Strong telephonic communication skills (preferred)
  • Certified Case Manager (CCM) certification (preferred)

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling
  • Financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

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