Care Manager RN - Remote CO

October 19, 2024

Industry: Private

Employment Type:- Full Time

Work Hours:- 8 Hours

Locations:- USA

Full Job Description:-

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

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Position Summary

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. 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.

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.
A private designated workspace free of distractions and high-speed internet

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
3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)
1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.
Must be willing and able to work Monday through Friday between the hours of 10:30am – 7:00pm EST for a scheduled 8- hour shift. Weekends and holidays may be required per the needs of the department.
1+ years of experience with Microsoft Office Suites

Preferred Qualifications

Central, Mountain, and Pacific Standard Time andidates preferred
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.
Strong telephonic communication and organizational skills
Excellent critical thinking skills