Remote RN Case Manager Telephonic Oncology Care

CVS Health Corporation; Bismarck (ND); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a remote RN Case Manager to support members nationwide via telephonic case management. The role involves applying clinical guidelines, coordinating care with physicians and care teams, and ensuring appropriate benefits utilization for fully and self-insured clients.

Candidate will use motivational interviewing to engage members, review medical necessity, and collaborate with supervisors to overcome barriers to care across multiple states.

Qualifications

• 5+ years' RN experience including at least 1 year in a hospital setting.
• Active multistate RN license via NLC for compact states.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Telephonic case management with patients and care teams.
• Apply criteria, guidelines and policies to assess benefits and member needs.
• Use clinical judgment to address risk factors and care planning barriers.
• Assess conditions including co-morbidities affecting functionality.
• Escalate cases and discuss in case conferences for multidisciplinary input.
• Use motivational interviewing to engage members and assess health needs.
• Perform medical necessity reviews.

Skills

RN

Case management

Multistate license (NLC)

Electronic documentation

Oncology experience

Education

Diploma or Associate Degree in Nursing

Tools

EMR systems

Job description

CVS Health is seeking a remote RN Case Manager to support members nationwide via telephonic case management. The role involves applying clinical guidelines, coordinating care with physicians and care teams, and ensuring appropriate benefits utilization for fully and self-insured clients.

Candidate will use motivational interviewing to engage members, review medical necessity, and collaborate with supervisors to overcome barriers to care across multiple states.