Field Case Manager, Registered Nurse (Pennsylvania)

Hispanic Alliance for Career Enhancement; Doylestown (Bucks County); On-site; USD 60,000 - 130,000; Full time

Job summary

Join a forward-thinking health solutions company as a Field Case Manager, Registered Nurse. This role involves assessing and coordinating comprehensive health needs for members, engaging with them through various channels. You'll work closely with multidisciplinary teams to promote wellness and ensure compliance with regulations. Enjoy a full-time position with competitive pay and benefits while making a significant impact on the lives of individuals in your community. If you're passionate about transforming health care and have the required experience, this is an exciting opportunity for you.

Benefits

Health Coverage

401(k)

Stock Purchase Plan

Wellness Programs

Flexible Benefits

Qualifications

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

Responsibilities

• Act as liaison among members, families, and providers.
• Coordinate case management activities for chronic members.
• Develop care plans to optimize health outcomes.

Skills

Analytical Skills

Problem-Solving Skills

Communication Skills

Organizational Skills

Interpersonal Skills

Education

Associates Degree or Nursing Diploma

Bachelor of Science in Nursing

Tools

MS Office

Proprietary Applications

Job description

Field Case Manager, Registered Nurse (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 uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

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

Travel: Up to 55 - 75% within designated area

Join our Community Care team as a leader in serving members through best-in-class operating and clinical models. This role involves assessing, planning, coordinating, and advocating for members' comprehensive health needs, working closely with providers, families, and community organizations to promote wellness and support timely return to work or optimal functioning.

Responsibilities

• Act as liaison among members, families, providers, insurers, and employers.
• Coordinate case management activities for catastrophic and chronically ill members, including referrals, home visits, and community resource utilization.
• Engage with members via phone or in person, including home, worksite, or physician visits.
• Assess medical and vocational status; develop care plans to optimize health outcomes and benefits eligibility.
• Communicate with stakeholders and document all case activities accurately.
• Collaborate with multidisciplinary teams to maximize health outcomes.
• Provide education and prevention information to members.
• Ensure compliance with relevant laws, regulations, and insurance requirements.
• Prepare reports and testify as needed.
• Monitor progress and adjust care plans to meet desired outcomes.

Minimum Qualifications

• Active Pennsylvania RN license.
• At least 3 years of clinical experience, preferably with Medicare members in areas like diabetes, CHF, CKD, post-acute, hospice, palliative, or cardiac care.
• 2 years of case management, discharge planning, or home health experience.
• Willingness to travel 55-75% within specified counties.

Preferred Qualifications

• Strong analytical and problem-solving skills.
• Excellent communication, organizational, and interpersonal skills.
• Ability to work independently, possibly remotely.
• Proficiency in MS Office and proprietary applications.
• Certified Case Manager preferred; additional certifications like CRC, CDMS, CRRN, COHN, CCM are a plus.
• Bachelor of Science in Nursing preferred.

Education

Associates degree or Nursing Diploma required.

Additional Details

Full-time, 40 hours/week. Pay range: $60,522 - $129,615, commensurate with experience. Benefits include health coverage, 401(k), stock purchase plan, wellness programs, and flexible benefits.

Application deadline: 05/30/2025. CVS Health is an equal opportunity employer committed to a diverse and inclusive workforce. Vaccination against COVID-19 is required unless a valid exemption is approved.

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 quality care accessible and affordable for all.