Case Manager Registered Nurse - FIELD - TEXAS - Dallas, Ellis, Navarro, Kaufman, Rockwall, Hunt[...]

Hispanic Alliance for Career Enhancement; Austin (TX); Remote; USD 60,000 - 130,000; Full time

Job summary

Join a leading health solutions company that is dedicated to transforming healthcare. In this role, you will work from home while also conducting home visits and engaging with members in your territory. As a Nurse Case Manager, you will assess, plan, and coordinate care to ensure optimal health outcomes for members. This position offers a competitive salary and comprehensive benefits, including medical plans, 401(k) matching, and wellness programs. Be part of a team that values diversity and inclusion, and make a meaningful impact on the lives of those you serve.

Benefits

401(k) plan with company matching

Affordable medical plan options

Employee stock purchase plan

Wellness screenings

Tobacco cessation programs

Weight management programs

Confidential counseling

Financial coaching

Flexible work schedules

Tuition assistance

Qualifications

• 3+ years clinical practice experience required.
• 1+ year of Case Management experience preferred.

Responsibilities

• Assess and coordinate case management activities for members.
• Develop proactive plans to enhance member wellness.

Skills

Clinical Practice

Case Management

Negotiation Skills

Motivational Interviewing

Bilingual Communication

Education

Bachelor's Degree in Nursing

Registered Nurse License

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 position is work from home and will require home visits and possible visits to Nursing Facility.

Local travel: 50-75% Territory includes Dallas, Ellis, Navarro, Kaufman, Rockwall, Hunt, Collin and/ or Tarrant county

- Nurse 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 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.

- Coordinates and implements assigned care plan activities and monitors care plan progress

- Conducts multidisciplinary review in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels

- Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs

- Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health

- Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices

- Helps member actively and knowledgeably participate with their provider in healthcare decision-making

- Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Required Qualifications

- License Registered Nurse, RN

- 3+ years clinical practice experience

- 1+ year Case Management experience

Preferred Qualifications

- MCO experience

- Star Kids experience

- Bilingual preferred
Education

- Bachelor's degree in nursing

- Licenses Registered Nurse

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, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/30/2025

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

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [e-mail] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.