Remote RN Case Manager — Community Care

CVS Health; Georgia; Hybrid; USD 54,000 - 143,000; Full time

Job summary

CVS Health is seeking a qualified RN Case Manager to coordinate and facilitate comprehensive care for members, assessing needs, developing personalized care plans, and coordinating services across providers. You will advocate for patients, communicate with providers and insurers, and monitor progress to promote positive outcomes.

The role requires an active RN license, 3+ years clinical experience, and 2+ years in case management or discharge planning.

Qualifications

• Active, unrestricted RN license in state of residence.
• 3+ years clinical experience, preference in diabetes, CHF, CKD, post-acute, hospice, palliative care, cardiac or Home Health with Medicare members.
• 2+ years in case management, discharge planning or home health coordination.

Responsibilities

• Coordinate and facilitate comprehensive care, assess needs and develop care plans.
• Advocate for patients, ensure effective communication and resource use.
• Interact with members telephonically or in person; may visit homes or physician offices.
• Develop plans to optimize wellness and medical outcomes; determine eligibility for benefits.
• Communicate with providers, attorneys, employers and insurers; document activities.
• Collaborate with multidisciplinary team and consult with physicians as needed.
• Provide education and prevention information; ensure compliance with laws and carrier requirements.
• Evaluate needs and eligibility; use clinical tools and data; monitor progress toward outcomes.

Skills

RN Licensure

Clinical Experience

Case Management

Discharge Planning

Medical Terminology

Digital Literacy

Communication Skills

Time Management

Interpersonal Skills

Bilingual Spanish

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Tools

Microsoft Word

Microsoft Excel

Outlook

PowerPoint

Job description

CVS Health is seeking a qualified RN Case Manager to coordinate and facilitate comprehensive care for members, assessing needs, developing personalized care plans, and coordinating services across providers. You will advocate for patients, communicate with providers and insurers, and monitor progress to promote positive outcomes.

The role requires an active RN license, 3+ years clinical experience, and 2+ years in case management or discharge planning.