Remote RN Case Manager – Telephonic Care Coordinator

CVS Health; Des Moines (IA); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

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 fully remote role. You will conduct telephonic case management with patients and care teams, applying clinical guidelines to determine benefits and coordinate care.

The ideal candidate has 5+ years as an RN with oncology experience, an active multistate license (NLC) or state-specific license, and proficiency in electronic documentation.

Qualifications

• 5+ years RN experience, including at least 1 year in a hospital setting
• RN must have active multistate license through NLC or state-specific license for non-compact states
• 1+ years' experience documenting electronically
• 1+ years' Oncology experience

Responsibilities

• Work as telephonic case manager for fully and/or self-insured clients.
• Apply criteria, guidelines, policies and regulatory standards to assess benefits and needs for appropriate benefits administration.
• Use clinical judgment to reduce risk factors and address barriers in care planning.
• Address conditions including co-morbidities impacting functionality.
• Consult with supervisor and others to overcome barriers and meet goals in case conferences.
• Collaborate with clinical colleagues and medical directors to optimize care and outcomes.
• Follow case management processes in line with policies and regulatory standards.
• Use motivational interviewing to maximize member engagement and assess health status and needs.
• Identify and escalate member needs following guidelines and protocols.
• Actively reach out to members to guide their care.
• Perform medical necessity reviews.

Skills

Registered Nurse

Case Management

Oncology experience

Multistate license (NLC)

Electronic documentation

Bilingual in Spanish

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 fully remote role. You will conduct telephonic case management with patients and care teams, applying clinical guidelines to determine benefits and coordinate care.

The ideal candidate has 5+ years as an RN with oncology experience, an active multistate license (NLC) or state-specific license, and proficiency in electronic documentation.