Remote RN Case Manager - Telephonic Care Coordinator

CVS Health; Frankfort (KY); À distance; USD 54 000 - 156 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health is seeking a Registered Nurse Case Manager for a remote, work-at-home role nationwide in the United States. The position involves telephonic case management for fully- and self-insured clients, applying clinical guidelines to determine benefits, and coordinating care with care teams and Medical Directors.

Ideal candidates have 5+ years RN experience (1 year in hospital), an active multistate license, and oncology experience. Spanish bilingual is a plus; BSN preferred.

Qualifications

• 5+ years' RN experience, including at least 1 year in a hospital setting.
• Active multistate license via NLC for compact states; state-specific licenses for non-compact states.
• 1+ years' experience documenting electronically.
• 1+ years' Oncology experience.
• Spanish bilingual preferred.
• BSN preferred.

Responsabilités

• Telephonic case management with patients and care teams for clients.
• Apply criteria and clinical guidelines to assess benefits and member needs.
• Use clinical judgment to reduce risk factors in care planning.
• Assess conditions including co-morbidities affecting functionality.
• Consult with supervisors and multidisciplinary teams to meet goals.
• Collaborate with clinical colleagues to overcome barriers.
• Follow case management processes per policies and procedures.
• Use motivational interviewing to engage members.
• Identify and escalate member needs per guidelines.
• Actively reach out to members to guide their care.
• Perform medical necessity reviews.

Connaissances

RN experience

Hospital experience

Electronic documentation

Oncology experience

Spanish (bilingual)

Formation

Diploma or Associates Degree in Nursing

Description du poste

CVS Health is seeking a Registered Nurse Case Manager for a remote, work-at-home role nationwide in the United States. The position involves telephonic case management for fully- and self-insured clients, applying clinical guidelines to determine benefits, and coordinating care with care teams and Medical Directors.

Ideal candidates have 5+ years RN experience (1 year in hospital), an active multistate license, and oncology experience. Spanish bilingual is a plus; BSN preferred.