Case Manager, Registered Nurse ( Montgomery, Berks, Bucks, Dauphin, Delaware, and Philadelphia [...]

Hispanic Alliance for Career Enhancement; Hershey (PA); On-site; USD 60,000 - 130,000; Full time

Job summary

An established industry player is seeking a dedicated Registered Nurse Case Manager to join their Community Care team. This role involves elevating patient care through collaboration with members, providers, and community organizations. You will have a profound impact on patient wellness by delivering community-based care tailored to individual needs. The ideal candidate will possess strong clinical experience, analytical skills, and a commitment to improving health outcomes. This exciting opportunity offers a supportive environment where your contributions will make a difference in the lives of many.

Benefits

Medical Options

401(k)

Employee Stock Purchase Plan

Wellness Programs

Paid Time Off

Flexible Schedules

Family Leave

Tuition Assistance

Qualifications

• Active Pennsylvania RN licensure required.
• 3+ years of clinical experience, preferably with Medicare members.
• 2+ years of case management or home health care experience.

Responsibilities

• Facilitate benefits delivery and promote wellness.
• Develop health strategies and policies for member wellness.
• Coordinate case management activities for chronically ill members.

Skills

Clinical Experience

Case Management

Analytical Skills

Communication Skills

Organizational Skills

Problem-Solving Skills

Education

Associates Degree or Nursing Diploma

Bachelor's of Science Degree in Nursing

Tools

MS Office

Proprietary Applications

Job description

Case Manager, Registered Nurse (Montgomery, Berks, Bucks, Dauphin, Delaware, and Philadelphia Counties, Pennsylvania)

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 more connected, more convenient, and more compassionate. We do this with heart, each and every day.

Position Summary

Schedule: Monday through Friday 8:00 AM - 5:00 PM EST

Travel: Up to 10-25% within Montgomery, Berks, Bucks, Dauphin, Delaware, and Philadelphia Counties.

Join our Community Care team to elevate patient care using best-in-class operating and clinical models. You will have a life-changing impact on our members by providing community-based, member-centric care that addresses healthcare and social needs through collaboration with members, providers, and community organizations.

Responsibilities

• Facilitate benefits delivery and healthcare information to determine eligibility and promote wellness.
• Develop and support health strategies, policies, and programs to ensure benefits delivery and member wellness.
• Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy to meet health needs.
• Act as liaison with members, families, employers, providers, insurance companies, and healthcare personnel.
• Coordinate case management activities for catastrophic and chronically ill members, including referrals, home visits, and community resources.
• Interact with members telephonically or in person, including home or workplace visits.
• Assess medical and vocational status, develop care plans, and facilitate appropriate condition management.
• Communicate with stakeholders and document activities accurately.
• Consult with multidisciplinary teams and healthcare providers to optimize outcomes.
• Provide educational and preventive information.
• Ensure compliance with laws, regulations, and insurance requirements.
• Conduct evaluations, monitor progress, and develop proactive strategies for member wellness and recovery.

Minimum Qualifications

• Active and unrestricted Pennsylvania RN licensure.
• At least 3 years of clinical experience, preferably with Medicare members (e.g., diabetes, CHF, CKD, post-acute, hospice, palliative, cardiac).
• Minimum 2 years of case management, discharge planning, or home health care coordination experience.
• Willingness to travel 10-25% within specified counties.

Preferred Qualifications

• Strong analytical and problem-solving skills.
• Excellent communication, organizational, and interpersonal skills.
• Ability to work independently, possibly from home.
• Proficiency with MS Office and proprietary applications.
• Certified Case Manager credential preferred.
• Additional certifications (CRC, CDMS, CRRN, COHN, CCM) are a plus.
• Bachelor's of Science Degree in Nursing preferred.

Additional Details

Associates degree or Nursing Diploma required. Anticipated weekly hours: 40. Time type: Full-time.

Pay range: $60,522.80 - $129,615.20, depending on experience and location. Position includes benefits, bonus, and incentive programs.

Benefits

Comprehensive benefits include medical options, 401(k), employee stock purchase plan, wellness programs, paid time off, flexible schedules, family leave, dependent care, tuition assistance, and more. For details, visit CVS Benefits.

Application deadline: 05/16/2025. CVS Health complies with all legal requirements regarding vaccination and accommodations. We are committed to diversity and inclusion, providing equal employment opportunities.

About CVS Health

We are dedicated to helping people on their path to better health through innovative health services, plans, and community pharmacy programs, making care more accessible, affordable, and seamless.