RN Case Manager: Managed Care & Member Wellness

CVS Health Corporation; Austin (TX); On-site; USD 54,000 - 117,000; Full time

Job summary

CVS Health is seeking a Nurse Case Manager to coordinate all case management activities with members, evaluating medical needs and promoting overall wellness. The role develops strategies to address issues and opportunities, and ensures programs comply with network management and clinical coverage policies.

Preferred qualifications include an active RN license, CCM certification is a plus, and the ability to travel up to 125 miles for a one-day field assignment.

Qualifications

• Current/Active Clinical Licensure (RN)
• Case Management experience
• Strong customer service orientation and problem solving
• Excellent Communication/Telephonic skills
• Excellent motivational interviewing skills/ability to build rapport and trust telephonically
• Excellence in documentation and respecting compliance/regulatory standards
• Highly organized, remain self-driven without direct supervision
• Manage time effectively
• Ability to travel within 125 miles round trip for 1 day in the field
• Variable work scheduled with ability to work 2 days weekly until 9pm local time.

Responsibilities

• Coordinates all case management activities with members to evaluate medical needs and facilitate overall wellness.
• Develops strategy to address issues to outcomes and opportunities to enhance members overall wellness through integration.
• Instructs programs and procedures in compliance with network management and clinical coverage policies.

Skills

RN licensure

Case management

Customer service

Communication

Motivational interviewing

Documentation

Organization

Time management

Travel ability

Education

Bachelor's or Master’s Degree

Job description

CVS Health is seeking a Nurse Case Manager to coordinate all case management activities with members, evaluating medical needs and promoting overall wellness. The role develops strategies to address issues and opportunities, and ensures programs comply with network management and clinical coverage policies.

Preferred qualifications include an active RN license, CCM certification is a plus, and the ability to travel up to 125 miles for a one-day field assignment.