Remote RN Case Manager — Wellness & Care Coordination

IntelliResume; Kentucky; Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an RN Case Manager for the Aetna One Advocacy program. The role involves assessing, planning, implementing, and coordinating case management to support member wellness. The position targets experienced nurses who enjoy delivering high-quality care and guidance.

With a Remote, OH location, this full-time role operates 8am-4:30pm EST, occasionally later shifts. Candidates should have a nursing license, 3+ years of experience, and the willingness to obtain additional state

Qualifications

• Associates Degree in Nursing is required.
• BSN preferred.
• 3+ years of clinical RN practice.
• Unrestricted RN license in state of residence; multi-state/compact privileges preferred.

Responsibilities

• Develop proactive plans to improve member outcomes and overall wellness.
• Evaluate member needs and benefit eligibility using clinical tools and data review.
• Apply clinical judgment to reduce risk factors and address complex health and social indicators.
• Assess members' conditions, including co-morbidities and multiple diagnoses affecting function.
• Review prior claims to evaluate impact on case management and eligibility.
• Assess work capacity and related restrictions/limitations.
• Refer to clinical resources as needed through a holistic approach.
• Consult with supervisors and present cases at conferences for multidisciplinary focus.
• Follow case management processes in line with regulatory and company policies.
• Engage members through interviews to determine health status and needs.

Education

Associates Degree in Nursing

BSN

Job description

CVS Health is seeking an RN Case Manager for the Aetna One Advocacy program. The role involves assessing, planning, implementing, and coordinating case management to support member wellness. The position targets experienced nurses who enjoy delivering high-quality care and guidance.

With a Remote, OH location, this full-time role operates 8am-4:30pm EST, occasionally later shifts. Candidates should have a nursing license, 3+ years of experience, and the willingness to obtain additional state