Remote RN Case Manager - Telephonic Care Coordination

CVS Health Corporation; Springfield (IL); Remote; 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 an experienced Registered Nurse Case Manager to support members across multiple states in a remote capacity. You will work telephonically with patients and care teams to interpret clinical guidelines, assess needs, and coordinate benefits and care plans.

With 5+ years as an RN and oncology background, you will navigate regulatory standards, document electronically, and collaborate with medical directors to optimize outcomes for fully and self-insured clients.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• Active multistate license through the Nurse Licensure Compact (NLC) or state-specific RN licenses for non-compact states.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Telephonic case management with patients and care teams for fully and/or self-insured clients.
• Apply criteria, clinical guidelines, and regulatory standards to assess benefits and member needs.
• Use clinical judgment to reduce risk factors and address complex health indicators.
• Assess information from multiple sources to address all conditions impacting functionality.
• Consult with supervisors and multidisciplinary teams to meet goals and improve claim management.
• Utilize case management processes in compliance with policies and procedures.

Skills

RN Case Manager

Oncology experience

Multistate license

Education

Diploma or Associates Degree in Nursing

Job description

CVS Health is seeking an experienced Registered Nurse Case Manager to support members across multiple states in a remote capacity. You will work telephonically with patients and care teams to interpret clinical guidelines, assess needs, and coordinate benefits and care plans.

With 5+ years as an RN and oncology background, you will navigate regulatory standards, document electronically, and collaborate with medical directors to optimize outcomes for fully and self-insured clients.