Remote RN Case Manager: Telephonic Care & Coordination

CVS Health; Salem (OR); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking an experienced Registered Nurse Case Manager for a remote role across the United States. The role involves telephonic case management, applying clinical guidelines, and coordinating care with patient care teams.

A multi-state license is required, with hospital experience and EMR documentation skills highly valued. The position offers full-time hours, a comprehensive benefits package, and a pay range that reflects geography, experience, and education.

Qualifications

• 5+ years' experience as a Registered Nurse with hospital setting exposure.
• Active multistate license via NLC or state-specific RN license per state supported.
• 1+ years' experience documenting electronically (EMR).
• Experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, or Medical/Surgical.

Responsibilities

• Serve as telephonic case manager for fully and/or self-insured clients.
• Apply clinical guidelines and regulatory standards to assess benefits and needs.
• Use holistic approach to address barriers and plan care with teams.
• Identify and escalate member needs following guidelines and protocols.
• Actively reach out to members to guide their care and conduct medical necessity reviews.
• Collaborate with supervisors, Medical Directors and programs to resolve issues.

Skills

Telephonic case management

Clinical judgment

Regulatory compliance

Multistate licensure (NLC)

Electronic medical records

Education

Nursing diploma or Associates Degree in Nursing

Job description

CVS Health is seeking an experienced Registered Nurse Case Manager for a remote role across the United States. The role involves telephonic case management, applying clinical guidelines, and coordinating care with patient care teams.

A multi-state license is required, with hospital experience and EMR documentation skills highly valued. The position offers full-time hours, a comprehensive benefits package, and a pay range that reflects geography, experience, and education.