Remote RN Case Manager: Telephonic Care Coordination

CVS Health; Springfield (IL); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical, dental & vision coverage

Paid time off

Retirement savings options

Wellness programs

Ongoing training and remote work

Job summary

CVS Health is seeking a remote RN Case Manager to support members nationwide with telephonic care management. The role includes collaboration with care teams, applying clinical guidelines, and ensuring appropriate benefits and care plans.

The ideal candidate has 5+ years as an RN, a multistate license preferred, and oncology experience. Training is provided, with a full benefits package and flexible remote work options.

Qualifications

• 5+ years' experience as a Registered Nurse, including in hospital settings.
• Must hold active RN license; multistate license via NLC preferred for cross-state work.
• Experience documenting electronically using a keyboard.
• 1+ years' Oncology experience.

Responsibilities

• Serve as a telephonic case manager for fully and/or self-insured clients.
• Apply clinical guidelines and regulatory standards to determine benefits and care plans.
• Use motivational interviewing to engage members and assess health needs.
• Collaborate with care teams and physicians to resolve care goals.
• Perform medical necessity reviews and coordinate across states.

Skills

Telephonic case management

RN license

Oncology experience

Electronic charting

Multistate license (NLC)

Spanish bilingual

Education

Diploma or Associate Degree in Nursing

Tools

MCG guidelines

NCCN guidelines

Lexicomp

Job description

CVS Health is seeking a remote RN Case Manager to support members nationwide with telephonic care management. The role includes collaboration with care teams, applying clinical guidelines, and ensuring appropriate benefits and care plans.

The ideal candidate has 5+ years as an RN, a multistate license preferred, and oncology experience. Training is provided, with a full benefits package and flexible remote work options.