Remote RN Case Manager: Telephonic Care Navigator

CVS Health; Jefferson City (MO); A distancia; USD 54.000 - 156.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement plan

Descripción de la vacante

CVS Health is seeking a licensed RN to perform remote telephonic case management for fully and self-insured clients across multiple states. You will assess needs, apply clinical guidelines, and coordinate care with care teams to ensure appropriate benefits and high-quality outcomes.

The ideal candidate has 5+ years nursing experience, multistate licensure via NLC, and UR/oncology experience. This full-time remote position offers 40 hours weekly and comprehensive benefits.

Formación

• 5+ years as a Registered Nurse with hospital experience.
• Active multistate license via NLC or state-specific licenses for non-compact states.
• Experience with Oncology, Transplant, Specialty Pharmacy, Pediatrics, or Maternity/Obstetrics preferred.

Responsabilidades

• Telephonic case management with patients and care teams.
• Assess benefits and member needs to ensure appropriate administration of benefits.
• Apply clinical guidelines and regulatory standards in care planning.
• Perform medical necessity reviews and coordinate care barriers to meet goals.
• Engage members using motivational interviewing to maximize engagement.

Conocimientos

Case management

Telephonic communication

Clinical judgment

Motivational interviewing

Regulatory compliance

Educación

Nursing diploma or Associate Degree in Nursing

Herramientas

Electronic health records (EHR)

Descripción del empleo

CVS Health is seeking a licensed RN to perform remote telephonic case management for fully and self-insured clients across multiple states. You will assess needs, apply clinical guidelines, and coordinate care with care teams to ensure appropriate benefits and high-quality outcomes.

The ideal candidate has 5+ years nursing experience, multistate licensure via NLC, and UR/oncology experience. This full-time remote position offers 40 hours weekly and comprehensive benefits.