Remote RN Case Manager: Coordinate Care & Empower Members

CVS Health; Idaho; Hybrid; USD 54,000 - 117,000; Full time

Job summary

CVS Health is seeking an RN Case Manager to join a 100% remote team. You will assess, plan, coordinate, and advocate for members to meet health needs while ensuring cost-effective outcomes. Duties include clinical assessments, discharge planning, and collaboration with medical directors.

The role requires an active RN license, 3+ years acute care, and strong communication and confidentiality skills. Work-from-home requirements emphasize secure, private space and reliable internet.

Qualifications

• Active and unrestricted RN license in state of residence with ability to obtain multi-state licensure upon hire.
• 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 escalation 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

Microsoft Office

Communication

Time management

Teamwork

Education

Associate degree in Nursing

Tools

Microsoft Office 365

Job description

CVS Health is seeking an RN Case Manager to join a 100% remote team. You will assess, plan, coordinate, and advocate for members to meet health needs while ensuring cost-effective outcomes. Duties include clinical assessments, discharge planning, and collaboration with medical directors.

The role requires an active RN license, 3+ years acute care, and strong communication and confidentiality skills. Work-from-home requirements emphasize secure, private space and reliable internet.