Remote RN Case Manager — Telephonic Care Navigator

CVS Health; Jefferson City (MO); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health is seeking a remote RN Case Manager to support members across multiple states. You will perform telephonic case management, apply evidence-based guidelines, and coordinate with clinicians to ensure appropriate benefits and outcomes.

The role requires 5+ years as an RN including oncology, with multistate licensing and strong documentation skills. AHH division offers comprehensive benefits and a national remote work model.

Qualifications

• RN with 5+ years of experience, including hospital setting
• Active multistate license per NLC to practice across states
• 1+ years' experience documenting electronically
• 1+ years' Oncology experience

Responsibilities

• Provide telephonic case management for fully and/or self-insured clients
• Apply clinical guidelines and care management plans to ensure appropriate benefits
• Reduce risk factors and address complex health and social indicators in care planning
• Assess information from multiple sources to address all conditions impacting functionality
• Escalate needs per guidelines and participate in case conferences
• Collaborate with clinical colleagues and supervisors to meet goals
• Follow case management processes in compliance with policies and regulations
• Use motivational interviewing to engage members effectively
• Identify and escalate member needs per protocols
• Proactively reach out to members to guide their care
• Perform medical necessity reviews

Skills

RN Case Manager

Multi-state license

Electronic charting

Oncology experience

Education

Diploma or ADN

Tools

MCG

NCCN

Lexicomp

Job description

CVS Health is seeking a remote RN Case Manager to support members across multiple states. You will perform telephonic case management, apply evidence-based guidelines, and coordinate with clinicians to ensure appropriate benefits and outcomes.

The role requires 5+ years as an RN including oncology, with multistate licensing and strong documentation skills. AHH division offers comprehensive benefits and a national remote work model.