Remote RN Case Manager – Telephonic Care Coordination

Adn Healthcare; Peoria (IL); On-site; USD 54,000 - 156,000; 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 RN Case Manager to support members nationwide from home with training provided. This telephonic role focuses on coordinating care for fully and/or self-insured clients, applying clinical guidelines and regulatory standards to assess benefits and needs.

The position requires 5+ years as a Registered Nurse and an active multi-state license. You will engage members through motivational interviewing, collaborate with care teams, and conduct medical necessity reviews,

Qualifications

• 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital setting.
• Active multistate license through the Nurse Licensure Compact (NLC) to practice across participating states.
• 1+ years' experience documenting electronically using a keyboard.
• Experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/ Obstetrics.

Responsibilities

• Work as a telephonic case manager with patients and their care team for fully and/or self-insured clients.
• Apply criteria and clinical guidelines, standardized care management plans, policies, procedures and regulatory standards while assessing benefits and/or member's needs.
• Use holistic approach and consult with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals.

Skills

Telephonic case management

Clinical judgment

Motivational interviewing

Care coordination

Education

Nursing diploma or Associates Degree in Nursing

Tools

EMR/electronic documentation

Job description

CVS Health is seeking a remote RN Case Manager to support members nationwide from home with training provided. This telephonic role focuses on coordinating care for fully and/or self-insured clients, applying clinical guidelines and regulatory standards to assess benefits and needs.

The position requires 5+ years as a Registered Nurse and an active multi-state license. You will engage members through motivational interviewing, collaborate with care teams, and conduct medical necessity reviews,