Remote RN Case Manager — Care Coordination Leader

CVS Health; United States; Remote; USD 61,000 - 130,000; Full time

Job summary

CVS Health is seeking a Community Care Case Manager to coordinate complex health needs for members and families in the South region. You will collaborate with providers, insurers, and care teams to assess, plan, implement, and evaluate case management services across settings, aiming for quality outcomes and cost efficiency.

Ideal candidates hold an RN license, have 3+ years of clinical experience and 2+ years in case management, and are proficient with MS Office and EHRs. Remote work possible.

Qualifications

• Active and unrestricted Compact RN licensure in OH or state of residence.
• 3+ years clinical practical experience with Medicare members.
• 2+ years case management, discharge planning, or home health care coordination.
• Reside in CVS Health South Region or willing to relocate.
• Bilingual Spanish preferred.

Responsibilities

• Serve as liaison with member/family, employer, providers, and insurers.
• Coordinate case management activities for catastrophic and chronically ill members across the continuum of care.
• Interact with members telephonically or in person; may meet at home, worksites, or physician offices.
• Assess medical and vocational status; develop a care plan to optimize wellness and outcomes.
• Communicate with stakeholders; document case work and outcomes.
• Consult with internal multidisciplinary team to maximize health outcomes.
• Provide educational and prevention information.
• Comply with laws and regulations for rehabilitation services; testify when required.
• Evaluate needs and determine benefit plan eligibility.

Skills

Spanish

Analytical skills

Problem-solving

Communication skills

Organizational skills

Interpersonal skills

Education

Associate's Degree or Nursing Diploma

Bachelor's Degree (preferred)

RN licensure (Compact state)

Tools

MS Office 365

EHR systems

Job description

CVS Health is seeking a Community Care Case Manager to coordinate complex health needs for members and families in the South region. You will collaborate with providers, insurers, and care teams to assess, plan, implement, and evaluate case management services across settings, aiming for quality outcomes and cost efficiency.

Ideal candidates hold an RN license, have 3+ years of clinical experience and 2+ years in case management, and are proficient with MS Office and EHRs. Remote work possible.