Remote RN Case Manager - Telephonic Care Coordinator

CVS Health; Santa Fe (NM); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a remote RN Case Manager to support members across multiple states from anywhere in the United States. This full-time role includes telephonic collaboration with patients and care teams to coordinate benefits and care plans.

You will apply clinical guidelines, assess needs, and overcome barriers to ensure appropriate utilization and high-quality outcomes. A nursing license and oncology experience are required or preferred, with a comprehensive benefits package offered.

Qualifications

• 5+ years of experience as a Registered Nurse
• Active multistate license via the Nurse Licensure Compact (NLC) for compact states
• 1+ years' experience documenting electronically
• 1+ years' experience in Oncology

Responsibilities

• Telephonic case management with patients and their care team for multiple 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
• Utilize information from various sources to address all conditions impacting functionality
• Escalate cases as needed and participate in case conferences for multidisciplinary review
• Collaborate with clinical colleagues and supervisors to overcome barriers to goals
• Follow case management processes in line with regulatory and company policies
• Conduct motivational interviewing to engage members and assess health needs
• Identify and escalate member needs following guidelines
• Proactively reach out to members to guide their care
• Perform medical necessity reviews

Skills

Registered Nurse (RN)

Case management

Multistate license (NLC)

Oncology experience

Electronic documentation

Bilingual Spanish (preferred)

Education

Diploma or Associates Degree in Nursing

Job description

CVS Health is seeking a remote RN Case Manager to support members across multiple states from anywhere in the United States. This full-time role includes telephonic collaboration with patients and care teams to coordinate benefits and care plans.

You will apply clinical guidelines, assess needs, and overcome barriers to ensure appropriate utilization and high-quality outcomes. A nursing license and oncology experience are required or preferred, with a comprehensive benefits package offered.