Case Manager RN

CVS Health; Fort Worth (TX); Remote; USD 60,000 - 130,000; Full time

Job summary

CVS Health is seeking a remote Case Manager RN. The role involves assessing patient needs, developing management plans, and ensuring high-quality customer service. A suitable candidate should possess a valid RN license and have substantial acute care experience. Key responsibilities include conducting comprehensive assessments and advocating for patient needs.

Benefits

Medical, dental, and vision benefits

401(k) retirement savings plan

Employee Stock Purchase Plan

Paid Time Off (PTO)

Short-term and long-term disability benefits

Qualifications

• Active RN license in state of residence required.
• 3+ years of acute care experience as an RN preferred.
• Willingness to obtain additional state licenses.

Responsibilities

• Conduct comprehensive clinical assessments.
• Develop and monitor case management plans.
• Advocate for patients regarding their healthcare coverage.

Skills

Decision-Making

Interpersonal Skills

Organizational Skills

Time Management

Education

Associate Degree

Job description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

This Case Manager RN position is 100% remote and the employee can live in any state.

Normal Working Hours: Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation per the needs of the business 12:30pm-9pm EST

No travel is expected with this position.

The Case Manager RN utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

The Case Manager RN process includes assessing the member's health status and care coordination needs, inpatient review, and discharge planning, developing, and implementing the case management plan, monitoring, and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria.

The Case Manager RN role requires a nurse that can exercise independent and sound judgment and someone that has strong decision-making skills and well-developed interpersonal skills. The Case Manager RN is expected to manage multiple priorities, demonstrate both effective organizational and time management skills as well demonstrate strong teamwork skills.

The responsibilities of this Case Manager RN position are to:

• Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and escalate quality of care issues through established channels.
• Provide an expected very high level of customer service.
• Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information, education, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices

Required Qualifications:

• Must have an active current and unrestricted RN license in state of residence.
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company)
• 3+ years of acute care experience as an RN required, Med Surge preferred
• Must be willing to work Monday through Friday 8:30am through 5:00pm in time zone of residence with an occasional late shift rotation per the needs of the business 12:30pm-9pm EST

Preferred Qualifications:

• Compact RN License or Multi state licensure
• Telephonic case management and/or telephonic experience

Education:

Associate Degree required

BSN preferred

Pay Range

The typical pay range for this role is:

$60,522.80 - $129,615.20

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

This Case Manager RN position is 100% remote and the employee can live in any state.

Normal Working Hours: Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation per the needs of the business 12:30pm-9pm EST

No travel is expected with this position.

The Case Manager RN utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

The Case Manager RN process includes assessing the member's health status and care coordination needs, inpatient review, and discharge planning, developing, and implementing the case management plan, monitoring, and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria.

The Case Manager RN role requires a nurse that can exercise independent and sound judgment and someone that has strong decision-making skills and well-developed interpersonal skills. The Case Manager RN is expected to manage multiple priorities, demonstrate both effective organizational and time management skills as well demonstrate strong teamwork skills.

The responsibilities of this Case Manager RN position are to:

• Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and escalate quality of care issues through established channels.
• Provide an expected very high level of customer service.
• Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information, education, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices

Required Qualifications:

• Must have an active current and unrestricted RN license in state of residence.
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company)
• 3+ years of acute care experience as an RN required, Med Surge preferred
• Must be willing to work Monday through Friday 8:30am through 5:00pm in time zone of residence with an occasional late shift rotation per the needs of the business 12:30pm-9pm EST

Preferred Qualifications:

• Compact RN License or Multi state licensure
• Certified Case Manager (CCM)
• Telephonic case management and/or telephonic experience

Education:

Associate Degree required

BSN preferred

Pay Range

The typical pay range for this role is:

$60,522.80 - $129,615.20

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 09/21/2024

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

About the company

At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.

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