Remote RN Case Manager - Telephonic Care Coordination

CVS Health; Columbus (OH); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Job summary

CVS Health is seeking an experienced RN Case Manager to join our remote team serving fully and self-insured clients across the United States. This telephonic role emphasizes care coordination, applying clinical guidelines, and facilitating appropriate benefits administration.

Candidates should have 5+ years of RN experience (including hospital exposure), a multistate license via the NLC or state licenses, and at least 1 year in oncology.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• Active multistate license via the Nurse Licensure Compact (NLC) or individual state licenses for each state supported.
• 1+ years' experience documenting electronically using a keyboard.
• 1+ years' experience in Oncology.

Responsibilities

• Support members across multiple states as telephonic case manager for fully and/or self-insured clients.
• Apply criteria, guidelines, and policies to assess benefits and member needs for appropriate care management.
• Use clinical judgment to address risks and barriers impacting care planning and outcomes.
• Collaborate with supervisors and multidisciplinary teams to overcome barriers and meet goals.
• Engage members to guide care and perform medical necessity reviews.

Skills

RN Case Management

Multistate licensure

Oncology experience

Electronic documentation

Education

Diploma or Associates Degree in Nursing

Job description

CVS Health is seeking an experienced RN Case Manager to join our remote team serving fully and self-insured clients across the United States. This telephonic role emphasizes care coordination, applying clinical guidelines, and facilitating appropriate benefits administration.

Candidates should have 5+ years of RN experience (including hospital exposure), a multistate license via the NLC or state licenses, and at least 1 year in oncology.