RN Case Manager — Community Care Champion

CVS Health; City of Albany (NY); A distancia; USD 67.000 - 143.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision coverage

Paid time off

Retirement savings options

Descripción de la vacante

CVS Health is seeking a dedicated RN Case Manager in New York to coordinate comprehensive care for members, develop personalized care plans, and liaise with providers, insurers, and families. This role emphasizes advocacy, resource utilization, and ongoing progress monitoring to improve outcomes and overall well-being.

The position requires NY licensure, clinical experience in relevant areas, and ability to manage multiple cases in a fast-paced environment, with remote-work options within state

Formación

• Active NY RN licensure
• 3+ years clinical experience with Medicare members (diabetes/CHF/CKD/post-acute/hospice/palliative/cardiac/Home Health)
• 2+ years case management, discharge planning or home health coordination
• Proficiency with MS Word, Excel, Outlook, PowerPoint
• Fast-paced, high-volume environment with strong time management
• Strong computer skills and ability to navigate multiple systems
• Strong medical terminology knowledge
• Ability to interact tactfully with customers and community
• Ability to handle sensitive information ethically and responsibly
• Spanish bilingual preferred

Responsabilidades

• Acts as liaison with member/family, employer, provider(s), insurers, and healthcare personnel.
• Coordinates case management for catastrophic and chronically ill members across care continuum.
• Interacts with members telephonically or in person; may visit homes, worksites or physician offices.
• Assesses medical and vocational status; develops care plans to optimize wellness and outcomes.
• Communicates with members and stakeholders; documents case work activities.
• Collaborates with internal multidisciplinary team to maximize health outcomes.
• Outreach to treating physicians or specialists as needed.
• Provides educational and preventive information.
• Applies laws and regulations for rehabilitation services and insurer requirements.
• Evaluates eligibility for benefits and uses clinical tools/data.
• Uses case management processes in line with policies.
• Facilitates appropriate condition management and timely return to baseline.

Conocimientos

RN licensure NY

Clinical experience

Case management

Time management

Communication skills

HIPAA/compliance

Digital literacy

Spanish bilingual (preferred)

Educación

Associate's Degree in Nursing (REQUIRED)

Bachelor's Degree in Nursing (PREFERRED)

Herramientas

Microsoft Word

Excel

Outlook

PowerPoint

Descripción del empleo

CVS Health is seeking a dedicated RN Case Manager in New York to coordinate comprehensive care for members, develop personalized care plans, and liaise with providers, insurers, and families. This role emphasizes advocacy, resource utilization, and ongoing progress monitoring to improve outcomes and overall well-being.

The position requires NY licensure, clinical experience in relevant areas, and ability to manage multiple cases in a fast-paced environment, with remote-work options within state