Remote RN Case Manager: Coordinate Care & Advocate

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

Job summary

CVS Health is seeking a Case Manager RN for a 100% remote role. The position supports members’ benefit plans and health needs through careful assessment, planning, and advocacy. Work hours are 8:00am–5:00pm in residence time zone with occasional evenings, weekends, and holidays.

Ideal candidates hold an RN license, 3+ years of acute care experience, and strong communication abilities. A BSN is preferred and telephonic case management experience is a plus.

Qualifications

• Active and unrestricted RN license in their state of residence.
• Minimum 3+ years of acute care experience as an RN.
• 3+ years of experience with Microsoft Suite of products.

Responsibilities

• Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans, or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and elevate quality of care issues through established channels.
• Provide an expected very high level of customer service.
• Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information, education, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

Skills

RN license

Acute care experience

Microsoft Office

Communication skills

Education

Associate Degree in Nursing

BSN preferred

Tools

Microsoft Office 365

Job description

CVS Health is seeking a Case Manager RN for a 100% remote role. The position supports members’ benefit plans and health needs through careful assessment, planning, and advocacy. Work hours are 8:00am–5:00pm in residence time zone with occasional evenings, weekends, and holidays.

Ideal candidates hold an RN license, 3+ years of acute care experience, and strong communication abilities. A BSN is preferred and telephonic case management experience is a plus.