Remote RN Case Manager – Telephonic Health Navigator

CVS Health Corporation; Des Moines (IA); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Paid Time Off

Retirement Savings

Job summary

CVS Health is seeking an experienced RN Case Manager to work remotely across the United States, with virtual training and support from AHH. The role focuses on telephonic case management for fully and self-insured clients, assessing needs, applying clinical guidelines, and coordinating care with care teams.

The ideal candidate has 5+ years as an RN, an active multistate license (NLC), oncology experience, and solid electronic documentation skills.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• Active multistate license via the Nurse Licensure Compact (NLC) for practice across participating states.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Telephonic case management with patients and care teams for fully and/or self-insured clients.
• Apply clinical guidelines, standardized care plans and regulatory standards while assessing benefits and member needs.
• Use clinical judgment to reduce risk factors and plan care addressing complex indicators.
• Assess information from multiple sources to address co-morbidities affecting functionality.
• Escalate and discuss cases at conferences for multidisciplinary input.
• Collaborate with clinical colleagues and supervisors to overcome barriers to goals and objectives.
• Follow case management processes compliant with policies and procedures.
• Use motivational interviewing to engage members and discern health needs.
• Identify and escalate member needs following guidelines.
• Actively reach out to members to guide their care.
• Perform medical necessity reviews.

Skills

Registered Nurse

Nurse Licensure Compact (NLC)

Education

Diploma or Associates Degree in Nursing

Job description

CVS Health is seeking an experienced RN Case Manager to work remotely across the United States, with virtual training and support from AHH. The role focuses on telephonic case management for fully and self-insured clients, assessing needs, applying clinical guidelines, and coordinating care with care teams.

The ideal candidate has 5+ years as an RN, an active multistate license (NLC), oncology experience, and solid electronic documentation skills.