Remote RN Case Manager – Community Care

CVS Health; Raleigh (NC); On-site; USD 54,000 - 117,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in Raleigh, NC is seeking a seasoned Community Care RN to elevate patient care through integrated case management. You will coordinate with members, providers, and care teams to address medical and social needs across the continuum.

You will assess, plan, and execute care plans, conduct home and telephonic outreach, and ensure timely benefits and return-to-baseline functioning while complying with HIPAA and regulatory requirements.

Qualifications

• Active and unrestricted Compact RN licensure in the states listed.
• 3+ years of clinical experience with Medicare members and chronic conditions.
• 2+ years case management, discharge planning or home health coordination.
• Proficiency with MS Office and some proprietary applications.
• Ability to work in a fast-paced, high-volume environment.
• Strong computer and multi-system navigation skills.

Responsibilities

• Liaise with members, families, employers, providers and carriers as appropriate.
• Coordinate case management for complex or chronic conditions across care continuum.
• Interact with members telephonically or in person; home visits may be required.
• Assess medical/vocational status and develop care plans to optimize outcomes.
• Communicate with stakeholders and document case activities.
• Consult with interdisciplinary team to maximize health outcomes.
• Provide education and prevention information; ensure regulatory compliance.
• Evaluate needs and determine benefit plan eligibility; facilitate integrations.
• Monitor progress toward outcomes and adjust plans as needed.

Skills

RN Licensure

Case Management

Discharge Planning

Home Health Coordination

Microsoft Word

Microsoft Excel

Microsoft Outlook

PowerPoint

Communication Skills

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Tools

Microsoft Word

Microsoft Excel

Outlook

PowerPoint

EHR Systems

Job description

CVS Health in Raleigh, NC is seeking a seasoned Community Care RN to elevate patient care through integrated case management. You will coordinate with members, providers, and care teams to address medical and social needs across the continuum.

You will assess, plan, and execute care plans, conduct home and telephonic outreach, and ensure timely benefits and return-to-baseline functioning while complying with HIPAA and regulatory requirements.