Remote RN Case Manager — Telephonic Care Coordination

CVS Health; Nevada; Hybrid; USD 54,000 - 156,000; Full time

Job summary

CVS Health is seeking an experienced RN Case Manager to work remotely from anywhere in the United States. You will coordinate telephonically with patients and care teams, applying clinical guidelines and regulatory standards to ensure appropriate benefits administration and high-quality care.

The role requires a RN with 5+ years of experience, a valid multistate license or state licenses, and strong documentation skills.

Qualifications

• 5+ years’ experience as a Registered Nurse with at least 1 year of experience in a hospital setting.
• Active multistate license via NLC or state-specific RN license for each state supported.
• 1+ years’ experience documenting electronically.
• 1+ years’ experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Med/Surg, Behavioral Health/Substance Abuse or Maternity/Obstetrics.

Responsibilities

• Work as a telephonic case manager with patients and care teams for fully and/or self-insured clients.
• Apply criteria and guidelines to assess benefits and member needs for appropriate benefits administration.
• Use clinical judgment to design strategies reducing risk factors and addressing complex health indicators.
• Assess information from multiple sources to address conditions and comorbidities affecting functionality.
• Consult with supervisors and teams to overcome barriers and meet goals in case conferences.

Skills

Registered Nurse

Case management

Telephonic care coordination

Electronic documentation

Education

Nursing diploma or Associate degree in Nursing

Tools

Electronic Health Records (EHR)

Job description

CVS Health is seeking an experienced RN Case Manager to work remotely from anywhere in the United States. You will coordinate telephonically with patients and care teams, applying clinical guidelines and regulatory standards to ensure appropriate benefits administration and high-quality care.

The role requires a RN with 5+ years of experience, a valid multistate license or state licenses, and strong documentation skills.