Pediatric Case Manager RN: Care Impact & Coordination

CVS Health Corporation; Austin (TX); On-site; USD 54,000 - 117,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation is seeking a dedicated pediatric case manager to coordinate case management activities, evaluate medical needs, and promote overall wellness for pediatric members. The role involves developing strategies to address outcomes in a managed care setting and ensuring compliance with coverage policies.

The position requires an RN license, active case management experience, strong communication and motivational interviewing skills, and willingness to travel within 125 miles for

Qualifications

• Must reside in Louisiana in one of the following parishes: Region-1: Orleans, Jefferson, St. Bernard and Plaquemines parishes.
• Active Clinical Licensure (RN)
• Case Management experience
• Strong customer service orientation and problem solving
• Excellent Communication/Telephonic skills
• Excellent motivational interviewing skills/ability to build rapport and trust telephonically
• Excellence in documentation and respecting compliance/regulatory standards
• Highly organized, remain self-driven without direct supervision
• Manage time effectively
• Pediatric experience
• Bachelor's and/or Master's Degree
• CCM Certification
• Previous experience in Managed Care Organization

Responsibilities

• Coordinates all case management activities with pediatric members to evaluate medical needs and to facilitate the overall wellness of pediatric members.
• Develops strategy to address issues to outcomes and opportunities to enhance members overall wellness through integration.
• Instructs programs and procedures in compliance with network management and clinical coverage policies.

Job description

CVS Health Corporation is seeking a dedicated pediatric case manager to coordinate case management activities, evaluate medical needs, and promote overall wellness for pediatric members. The role involves developing strategies to address outcomes in a managed care setting and ensuring compliance with coverage policies.

The position requires an RN license, active case management experience, strong communication and motivational interviewing skills, and willingness to travel within 125 miles for