Remote RN Case Manager - Care Coordination

4062 Aetna Resources, LLC; Ohio; Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Paid time off

Remote work environment

Job summary

CVS Health is hiring a Case Manager RN to provide remote, patient-centered care coordination from home. You will assess, plan, advocate, and monitor cases to meet benefit plan and health needs, with collaboration across care teams and vendors. Strong clinical judgment and communication are essential.

The role supports a 40-hour work week with occasional after-hours and weekend coverage as needed, and requires a valid RN license and multi-state licensure eligibility.

Qualifications

• Active and unrestricted RN license in their state and ability to obtain multi-state licensure upon hire.
• 3+ years of acute care experience as an RN.
• 3+ years of experience with Microsoft Suite of products.
• Strong problem-solving and clinical decision-making skills.
• Ability to manage sensitive information with professionalism and confidentiality.
• Excellent communication and relationship-building skills.
• Ability to work effectively with diverse patient populations and healthcare teams.

Responsibilities

• Apply data-driven methods to identify members and tailor case management plans.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on plans and programs.
• Advocate for patients to maximize health care coverage.
• Promote quality and cost-effective outcomes and improve operations.
• Identify and escalate quality of care issues through established channels.
• Provide high-level customer service and support member engagement.
• Assess health literacy and readiness to change; tailor approaches accordingly.
• Coach and educate members to empower independent medical and healthy-lifestyle decisions.

Skills

RN license

Acute care RN

Microsoft Office

Communication skills

Time management

Education

Associate Degree in Nursing

BSN preferred

Tools

Microsoft Office 365

Teams

EHR portal

Job description

CVS Health is hiring a Case Manager RN to provide remote, patient-centered care coordination from home. You will assess, plan, advocate, and monitor cases to meet benefit plan and health needs, with collaboration across care teams and vendors. Strong clinical judgment and communication are essential.

The role supports a 40-hour work week with occasional after-hours and weekend coverage as needed, and requires a valid RN license and multi-state licensure eligibility.