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

The Muse; Norfolk (VA); On-site; USD 60,000 - 130,000; Full time

Job summary

A leading healthcare provider is seeking a Case Manager Registered Nurse for the Tidewater Region of Virginia. This role involves assessing, planning, and coordinating case management activities to enhance member wellness through direct engagement and collaboration with healthcare teams. The ideal candidate will possess a Virginia RN license, extensive experience, and strong communication skills.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Confidential counseling services

Tuition assistance

Qualifications

• Virginia LPN/RN/BH License required.
• 3 years Clinical Experience in nursing or related fields.
• 1+ years Managed Care experience.

Responsibilities

• Assessing and coordinating all case management activities.
• Developing proactive action plans for member wellness.
• Conducting evaluations of member needs and benefit eligibility.

Skills

Effective communication skills

Clinical Judgment

Patient Assessment

Education

Associate's Degree in Nursing

Bachelor's Degree of Science & Nursing (Preferred)

Job description

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

Join to apply for the Case Manager Registered Nurse (Field Must reside in Tidewater Region Virginia) role at The Muse

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

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Join to apply for the Case Manager Registered Nurse (Field Must reside in Tidewater Region Virginia) role at The Muse

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 SummaryThis 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 faceTypical office working environment with productivity and quality expectations

Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening.

Work requires sitting for extended periods, talking on the telephone, and typing on the computerNurse Case Manager is responsible for 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. Services strategies policies and programs are comprised of network management and clinical coverage policies. Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and 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 and address complex health and social indicators which impact care planning and resolution of member issues. 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. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. 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

• 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/BH with current unrestricted Virginia state licensure required.
• 3 years Clinical Experience (Preferably in Medical-Surgical Nursing, Behavioral Health, Long term Care, etc.)
• 1+ years Managed Care experience.
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
  
  

Preferred Qualifications

• Case Management in an integrated model preferred 5 years clinical practice experience
• Effective communication skills, both verbal and written.
• Bilingual in English/Spanish
  
  

Education

• Associate's Degree Required, preferably in a Nursing degree
• Bachelor's Degree of Science & Nursing Preferred
  
  

Anticipated Weekly Hours

40Time Type

Full timePay Range

The typical pay range for this role is:$60,522.00 - $129,615.00This 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 peopleWe 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, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 06/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Technology, Information and Internet

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