Remote RN Case Manager – Telephonic & Care Coordination

CVS Health Corporation; Lansing (MI); À distance; USD 54 000 - 156 000; Plein temps

Résumé du poste

CVS Health Corporation is seeking a remote RN case manager to support members across multiple states. You will conduct telephonic assessments, apply clinical guidelines, and coordinate care with care teams to optimize outcomes. The role requires strong documentation and utilization review experience.

The position offers full-time remote work, competitive benefits, and training resources. Licensure through NLC or state-specific licenses is required, with eligibility across compact states in the

Qualifications

• RN license valid in participating states via NLC or individual state licenses
• 5+ years RN experience with hospital setting
• 1+ years’ experience documenting electronically
• Experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/Obstetrics preferred

Responsabilités

• Telephonic case management with patients and care teams for fully and/or self-insured clients
• Apply clinical guidelines and utilization management standards to assess benefits and member needs
• Use holistic approaches to reduce risk factors and address barriers to care
• Collaborate with supervisors and multidisciplinary teams to resolve complex cases
• Perform medical necessity reviews and ensure regulatory compliance

Connaissances

Case management

Nursing

Telephonic coordination

Formation

Nursing Diploma/Associate Degree

Outils

MCG

NCCN

Lexicomp

Description du poste

CVS Health Corporation is seeking a remote RN case manager to support members across multiple states. You will conduct telephonic assessments, apply clinical guidelines, and coordinate care with care teams to optimize outcomes. The role requires strong documentation and utilization review experience.

The position offers full-time remote work, competitive benefits, and training resources. Licensure through NLC or state-specific licenses is required, with eligibility across compact states in the