A1A Case Manager RN - Registered Nurse - AZ

IntelliResume; Tucson (AZ); Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs and other resources

Job summary

CVS Health is seeking a Case Manager RN for the A1A program to perform telephonic and face-to-face assessments, plan and coordinate care to improve member wellness. This role is remote from AZ with a schedule 8am-4:30pm AZ time.

Applicants should have an Associate Degree in Nursing, 3+ years RN experience, and an active RN license with multistate capabilities. Willingness to obtain all 50 state licenses on hire. Benefits include medical/dental/vision and PTO.

Qualifications

• Associates Degree in Nursing required, BSN preferred.
• 3+ years of clinical RN experience required.
• Current RN license in home state, multi-state/compact preferred.
• Willingness to obtain all 50 state licenses on hire.

Responsibilities

• Develop proactive plans to improve member outcomes and wellness.
• Evaluate member needs and benefit plan eligibility using clinical tools.
• Apply clinical judgment to reduce risks and address complex health indicators.
• Assess members' conditions, co-morbidities and multiple diagnoses.
• Review prior claims to evaluate impact on current case management.
• Assess members' work capacity and related restrictions.
• Refer to clinical resources using a holistic approach.
• Consult with supervisors to overcome barriers to goals.
• Present cases at conferences for multidisciplinary review.

Skills

RN

Clinical assessment

Care coordination

Regulatory compliance

Education

Associate Degree in Nursing

BSN preferred

Job description

About This Role

The A1A Case Manager RN role at CVS Health involves telephonic and face-to-face assessments, planning, implementing, and coordinating case management activities to enhance member wellness. This position is ideal for experienced RNs looking to make a significant impact in healthcare delivery.

Highlights

• Pay: $60,522 - $129,615/year
• Location: Remote, AZ
• Brand/Division: Aetna One Advocacy (A1A)
• Schedule: Full-time, 8am-4:30pm AZ Time
• Residency: Must reside within a commutable distance of Phoenix, AZ (typically within 45 minutes maximum)

What You'll Do

• Develop proactive courses of action to enhance member outcomes and overall wellness.
• Conduct evaluations of member needs and benefit plan eligibility using clinical tools.
• Apply clinical judgment to reduce risk factors and address complex health indicators.
• Assess members' conditions, including co-morbidities and multiple diagnoses.
• Review prior claims to evaluate their impact on current case management.
• Assess members' work capacity and related restrictions/limitations.
• Use a holistic approach to determine the need for referrals to clinical resources.
• Consult with supervisors to overcome barriers in meeting goals and objectives.
• Present cases at conferences for multidisciplinary focus on claim management.
• Utilize case management processes in compliance with regulatory and company policies.

Requirements

Education:

• Associates Degree in Nursing required, BSN preferred.

Experience:

• 3+ years of clinical practice experience as an RN required.

Licenses & Certifications:

• Current RN License in state of residence required, preferably with multi-state/compact privileges.
• Must be willing to obtain all 50 state licenses upon hire.

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources

About CVS Health

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on innovation and accountability, striving to simplify healthcare for individuals and communities.