Remote RN Case Manager – Health Care Coordination

CVS Health; Florida; Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Remote Case Manager – Registered Nurse (RN) to assess, plan, implement and coordinate case management activities for members nationwide. This blended role covers case and utilization management, with a focus on improving overall wellness and safe transitions into CVS Health programs.

Requirements include active compact RN licensure, 5+ years clinical nursing, 2+ years critical care, and 6+ months in case/ utilization management.

Qualifications

• Active, current compact RN licensure in the state of residence.
• Minimum 5 years of clinical nursing experience.
• 2+ years experience in critical care.
• 6+ months in case management or utilization management.
• Must be able to work Monday–Friday 8 AM to 5 PM in the time zone of residence.
• Must be able to obtain multi state RN licensures.

Responsibilities

• Assess, plan, implement, and coordinate case management activities.
• Evaluate medical needs to promote member wellness.
• Review prior claims to assess impact on case management.
• Collaborate with supervisors and teams in case conferences.
• Ensure compliance with regulatory and company policies.
• Engage members via interview to determine health needs.

Skills

RN licensure

Clinical nursing

Case management

Critical care

Communication

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Tools

EHR systems

Microsoft Office 365

Job description

CVS Health is seeking a Remote Case Manager – Registered Nurse (RN) to assess, plan, implement and coordinate case management activities for members nationwide. This blended role covers case and utilization management, with a focus on improving overall wellness and safe transitions into CVS Health programs.

Requirements include active compact RN licensure, 5+ years clinical nursing, 2+ years critical care, and 6+ months in case/ utilization management.