Case Manager Registered Nurse (Field – Must reside in Tidewater Region Virginia)

CVS Health; Norfolk (VA); On-site; USD 60,000 - 130,000; Full time

Job summary

Join CVS Health as a Case Manager Registered Nurse and become part of a dedicated team focused on improving healthcare outcomes. This role will require you to assess members' needs, engage closely with them while traveling across the Tidewater Region, and apply your clinical judgment to enhance wellness through proactive case management.

Benefits

Affordable medical plan options

401(k) plan with company matching

Flexible work schedules

Tuition assistance

Confidential counseling

Qualifications

• Must possess current unrestricted Virginia state licensure.
• 3 years of clinical experience preferred in Medical-Surgical Nursing or related fields.
• Position requires 1+ years of managed care experience.

Responsibilities

• Responsible for assessing, planning, and implementing case management activities.
• Traveling 50-75% of the time for face-to-face meetings with members.
• Utilizes interview skills to ensure maximum member engagement.

Skills

Clinical experience

Communication skills

Bilingual in English/Spanish

Education

Associate's Degree in Nursing

Bachelor's Degree of Science & Nursing

Tools

Computer skills

Job description

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

This Case Manager Registered Nurse position is with Aetna’s Long-Term Services and Supports (LTSS) team and is a field-based position out of the Tidewater Region Virginia, specifically the Norfolk Area. The requirements is for candidates to hold a Virginia LPN, RN, or BH License, and travel 50-75% of the time to meet with members face to face

Typicalofficeworkingenvironmentwithproductivityandquality expectations

Workrequirestheabilitytoperformcloseinspectionofhandwrittenand computergenerateddocumentsaswellasaPCmonitor. Sedentaryworkinvolvingperiodsofsitting,talking,listening.

Work requires sitting for extended periods, talking on the telephone, and typing on the computer

NurseCaseManagerisresponsiblefor assessing,planning,implementingandcoordinatingallcasemanagement activitieswithmemberstoevaluatethemedicalneedsofthememberto facilitatethemember’soverallwellness.Developsaproactivecourseof actiontoaddressissuespresentedtoenhancetheshortandlong- term outcomesaswellasopportunitiestoenhanceamember’soverallwellness throughintegration.Servicesstrategiespoliciesandprogramsare comprisedofnetworkmanagementandclinicalcoveragepolicies.Throughtheuseofclinicaltoolsandinformation/datareview,conductsan evaluationofmember'sneedsandbenefitplaneligibilityandfacilitates integrativefunctionsaswellassmoothtransitiontoAetnaprogramsand plans.Appliesclinicaljudgmenttotheincorporationofstrategiesdesigned toreduceriskfactorsandbarriersandaddresscomplexhealthandsocial indicatorswhichimpactcareplanningandresolutionofmemberissues. Assessmentstakeintoaccountinformationfromvarioussourcestoaddress allconditionsincludingco-morbidandmultiplediagnosesthatimpact functionality.Reviewspriorclaimstoaddresspotentialimpactoncurrent casemanagementandeligibility.Assessmentsincludethemember’slevelof workcapacityandrelatedrestrictions/limitations.Usingaholisticapproach assesstheneedforareferraltoclinicalresourcesforassistancein determiningfunctionality.Consultswithsupervisorandothersin overcomingbarriersinmeetinggoalsandobjectives,presentscasesat caseconferencesformultidisciplinaryfocustobenefitoverallclaim management.Utilizescasemanagementprocessesincompliancewith regulatoryandcompanypoliciesandprocedures.Utilizesinterviewingskills toensuremaximummemberengagementanddiscerntheirhealthstatus andhealthneedsbasedonkeyquestionsandconversation.

Required Qualifications

• Candidate must reside in Tidewater Region Virginia, specifically the Norfolk Area

• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time. Mileage is reimbursed per our company expense reimbursement policy

• LPN/RN/BHwithcurrentunrestrictedVirginia statelicensurerequired.

• 3 years Clinical Experience (Preferably in Medical-Surgical Nursing, Behavioral Health, Long term Care, etc.)

• 1+ years Managed Care experience.

• Positionrequiresproficiencywithcomputerskillswhichincludesnavigating multiplesystemsandkeyboarding.

Preferred Qualifications

• CaseManagementinanintegratedmodelpreferred 5yearsclinicalpracticeexperience

• Effectivecommunicationskills,bothverbalandwritten.

• Bilingual in English/Spanish

Education

• Associate's Degree Required, preferably in a Nursing degree

• Bachelor's Degree of Science & Nursing Preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visithttps://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.