Remote RN Case Manager: Telephonic Care Navigator

CVS Health; Charleston (WV); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a remote RN Case Manager to support fully- and self-insured members across the US. You will assess needs, apply guidelines, and develop care plans with physicians and care teams in a telephonic role requiring strong clinical judgment and multi-state licensure via the Nurse Licensure Compact.

Experience in oncology and electronic documentation is preferred. You will perform medical necessity reviews, engage members to improve outcomes, and work with supervisors in case

Qualifications

• RN with 5+ years of experience, including hospital setting.
• Active multistate license via NLC or state-specific licenses.
• 1+ years' oncology experience and electronic documentation proficiency.

Responsibilities

• Telephonic case management with patients and care teams.
• Apply criteria and clinical guidelines to assess benefits and needs.
• Conduct medical necessity reviews and address barriers to care.
• Collaborate with supervisors and medical directors on cases.
• Engage members to maximize outcomes using motivational interviewing.

Skills

RN Experience

NLC License

Oncology Experience

Electronic Documentation

Spanish Language (Preferred)

Education

Diploma or Associates Degree in Nursing

Tools

MCG

NCCN

Lexicomp

Job description

CVS Health is seeking a remote RN Case Manager to support fully- and self-insured members across the US. You will assess needs, apply guidelines, and develop care plans with physicians and care teams in a telephonic role requiring strong clinical judgment and multi-state licensure via the Nurse Licensure Compact.

Experience in oncology and electronic documentation is preferred. You will perform medical necessity reviews, engage members to improve outcomes, and work with supervisors in case