Remote RN Case Manager: Telephonic Care Coordinator

CVS Health; Helena (MT); Remote; USD 54,000 - 156,000; Full time

Job summary

CVS Health is seeking an experienced RN Case Manager to work remotely across the United States. The role involves telephonic case management for fully and self-insured clients, applying clinical guidelines, and coordinating with care teams to ensure appropriate benefits and outcomes.

A strong oncology background and active multistate license are required. Applicants should have hospital experience, electronic charting proficiency, and be comfortable with regulatory standards while guiding

Qualifications

• 5+ years of RN experience, including hospital work.
• Active multistate license via NLC for practice across states.
• Proficient electronic documentation experience.
• Experience in Oncology is required.

Responsibilities

• Serve as telephonic case manager for fully/self-insured clients.
• Apply criteria and guidelines to assess benefits and member needs.
• Use clinical judgment to reduce risk factors and plan care.
• Address comorbidities affecting care planning.
• Discuss cases in conferences for multidisciplinary input.
• Coordinate with colleagues to overcome barriers to goals.
• Follow case management processes per policy and regulation.
• Use motivational interviewing to engage members.
• Identify escalations and guide members per guidelines.
• Reach out to members to coordinate care and support.
• Perform medical necessity reviews.

Skills

RN experience

Multistate license (NLC)

Electronic charting

Oncology experience

Education

Diploma or Associate Degree in Nursing

Tools

MCG

NCCN

Lexicomp

Job description

CVS Health is seeking an experienced RN Case Manager to work remotely across the United States. The role involves telephonic case management for fully and self-insured clients, applying clinical guidelines, and coordinating with care teams to ensure appropriate benefits and outcomes.

A strong oncology background and active multistate license are required. Applicants should have hospital experience, electronic charting proficiency, and be comfortable with regulatory standards while guiding