Remote RN Case Manager: Telephonic Care Coordination

CVS Health; Trenton (NJ); 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 in the United States is seeking a remote RN Case Manager to provide telephonic care coordination for fully and self-insured clients, with virtual training.

The role requires 5+ years as a Registered Nurse, multistate licensure, and oncology experience; there is a strong emphasis on clinical judgment, motivational interviewing, and adherence to URAC standards.

This full-time position offers comprehensive benefits and the opportunity to support members across multiple states from home.

Qualifications

• 5+ years as a Registered Nurse, including at least 1 year in a hospital setting.
• Active multistate license via the Nurse Licensure Compact (NLC) to practice across participating states.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Provide telephonic case management for fully and/or self-insured clients.
• Apply criteria and clinical guidelines to assess benefits and member needs.
• Use clinical judgment to reduce risk factors and address barriers in care planning.
• Assess conditions including co-morbidities that impact care.
• Collaborate with supervisors and teams; present cases in case conferences.
• Coordinate with clinical colleagues to overcome barriers and meet goals.
• Follow case management processes in compliance with policies.
• Use motivational interviewing to engage members and discern needs.
• Identify and escalate member needs per guidelines.
• Proactively reach out to members to guide their care.
• Perform medical necessity reviews.

Skills

Telephonic case management

Clinical judgment

Motivational interviewing

Multistate license (NLC)

Oncology experience

Education

Diploma/Associates in Nursing

BSN preferred

Job description

CVS Health in the United States is seeking a remote RN Case Manager to provide telephonic care coordination for fully and self-insured clients, with virtual training.

The role requires 5+ years as a Registered Nurse, multistate licensure, and oncology experience; there is a strong emphasis on clinical judgment, motivational interviewing, and adherence to URAC standards.

This full-time position offers comprehensive benefits and the opportunity to support members across multiple states from home.