Remote Case Manager RN: Care Coordination & Advocacy

CVS Health; Tennessee; Hybrid; USD 54,000 - 130,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

Retirement options

Bonus eligibility

Job summary

CVS Health is seeking a Case Manager RN for a fully remote role, allowing residency in any state. The position emphasizes assessment, planning and advocacy to align with the member's benefit plan and health needs while coordinating care and ensuring cost-effective outcomes.

The ideal candidate holds an active RN license, has 3+ years acute care experience, and is prepared to obtain additional state licenses. Strong communication, data-driven planning, and collaboration are essential for success.

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.
• Must be willing to work 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 11:00 AM-8:00 PM EST (once per Quarter).

Responsibilities

• 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 elevate 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

Skills

RN license

Case management

Telephonic CM

Communication skills

Education

Associate degree

Bachelor's degree preferred

Tools

EHR systems

Microsoft Office 365

Job description

CVS Health is seeking a Case Manager RN for a fully remote role, allowing residency in any state. The position emphasizes assessment, planning and advocacy to align with the member's benefit plan and health needs while coordinating care and ensuring cost-effective outcomes.

The ideal candidate holds an active RN license, has 3+ years acute care experience, and is prepared to obtain additional state licenses. Strong communication, data-driven planning, and collaboration are essential for success.