Remote RN Case Manager for Medicare/Medicaid Care

CVS Health; Edison (NJ); On-site; USD 67,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement options

Job summary

CVS Health is seeking a remote ICM Case Manager to develop proactive care plans for members with Medicare/Medicaid and complex health and social needs. The role involves coordinating with members, providers, and community resources to optimize overall wellness.

Requires active NJ RN license, 3+ years clinical practice, and 25-50% travel within Middlesex County. Home-based setup and strong communication are essential for success.

Qualifications

• Active and unrestricted RN licensure in NJ.
• Minimum 3+ years of clinical practice.
• Willing and able to travel 25-50% using your own vehicle.
• Must reside close to or within Middlesex County, New Jersey.

Responsibilities

• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to address risk factors and barriers affecting care planning.
• Conducts assessments from multiple sources to address conditions and functional impact.
• Assesses need for referrals to clinical resources and interdisciplinary team members.
• Collaborates with supervisor and stakeholders to overcome barriers and present cases at conferences.
• Implements case management processes in compliance with policies and procedures and uses motivational interviewing to engage members.

Skills

Clinical practice

Communication skills

Independent work

Analytical skills

Travel readiness

Education

Associate's Degree

Bachelor's Degree preferred

Tools

MS Word

Excel

Outlook

PowerPoint

Teams

Job description

CVS Health is seeking a remote ICM Case Manager to develop proactive care plans for members with Medicare/Medicaid and complex health and social needs. The role involves coordinating with members, providers, and community resources to optimize overall wellness.

Requires active NJ RN license, 3+ years clinical practice, and 25-50% travel within Middlesex County. Home-based setup and strong communication are essential for success.