Remote RN Case Manager — IL-Licensed

CVS Health; Springfield (IL); Remote; USD 67.000 - 143.000; Vollzeit

Zusammenfassung

CVS Health is seeking an experienced RN Case Manager to work remotely from home. Candidates must hold an active Illinois RN license, though residency in Illinois is not required. Typical hours are Monday through Friday, 9:00 am to 5:30 pm in the residence time zone, with occasional later shifts until 8:00 pm EST.

40-hour work week; no weekends or holidays. You will assess member needs, determine eligibility for benefits, coordinate with care teams, and support smooth transitions to CVS Health

Qualifikationen

• Active Illinois RN licensure required (does not need to live in Illinois).
• 2+ years of clinical experience as an RN.
• Experience across Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical/Surgical, Orthopedics, Long Term Care, and Infusion nursing.

Aufgaben

• Develops a proactive plan to address issues and improve short- and long-term outcomes and overall wellness.
• Evaluates member needs and benefit plan eligibility using clinical tools and data; facilitates transitions to Aetna programs and plans.
• Applies clinical judgement to reduce risk factors and address social indicators impacting care planning and resolution of issues.
• Considers information from multiple sources to address conditions including co-morbidities and functional impact.
• Reviews prior claims to assess potential impact on current case management and eligibility.
• Assesses work capacity and related restrictions/limitations.
• Assesses need for referrals to clinical resources and supports appropriate actions.
• Collaborates with supervisor and team to overcome barriers and presents cases in multidisciplinary meetings.

Kenntnisse

Telephonic communication

Ausbildung

Associate’s degree in nursing

BSN preferred

Tools

Microsoft Office 365

Google Workspace

Jobbeschreibung

CVS Health is seeking an experienced RN Case Manager to work remotely from home. Candidates must hold an active Illinois RN license, though residency in Illinois is not required. Typical hours are Monday through Friday, 9:00 am to 5:30 pm in the residence time zone, with occasional later shifts until 8:00 pm EST.

40-hour work week; no weekends or holidays. You will assess member needs, determine eligibility for benefits, coordinate with care teams, and support smooth transitions to CVS Health