Remote RN Case Manager & Care Navigator

CVS Health; Augusta (ME); Remote; USD 54,000 - 156,000; Full time

Job summary

CVS Health is seeking a seasoned RN Case Manager for a remote, nationwide role. You will conduct telephonic case management, applying clinical guidelines to assess member needs and benefits while coordinating care with care teams.

The position requires 5+ years as an RN, oncology experience, and a multistate license (NLC preferred). Diploma/Associates in Nursing and electronic documentation experience are required. Full-time role with comprehensive benefits.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• RN with multistate license via NLC or state-specific licenses for each state supported.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Work as a telephonic case manager with patients and care teams for fully and/or self-insured clients.
• Apply criteria and clinical guidelines to assess benefits and member needs for appropriate administration of benefits.
• Use holistic approach and motivational interviewing to engage members and address health needs.
• Coordinate with supervisors and clinicians to overcome barriers and meet goals.
• Perform medical necessity reviews and ensure regulatory compliance.

Skills

RN Case Manager

Clinical assessment

Telephonic case management

Education

Diploma or Associate Degree in Nursing

Job description

CVS Health is seeking a seasoned RN Case Manager for a remote, nationwide role. You will conduct telephonic case management, applying clinical guidelines to assess member needs and benefits while coordinating care with care teams.

The position requires 5+ years as an RN, oncology experience, and a multistate license (NLC preferred). Diploma/Associates in Nursing and electronic documentation experience are required. Full-time role with comprehensive benefits.