RN Case Manager: Wellness & Care Coordination

CVS Health; United States; Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a registered nurse to perform case management, coordinating care for members via telephonic and face-to-face encounters. The RN will assess medical needs, plan interventions, and coordinate with appropriate programs to improve overall wellness.

This is a full-time role with a focus on patient-centered care and collaboration with multidisciplinary teams. The position requires an active RN license, 3+ years of clinical practice, and strong communication and bilingual

Qualifications

• RN licensure in the state of residence (multi-state/compact preferred).
• Minimum 3 years of clinical practice experience.
• Bachelor’s degree preferred; associate’s degree required.
• Bilingual English/Spanish is a plus.

Responsibilities

• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.
• Through clinical tools and information/data review, evaluates member needs and benefit plan eligibility and facilitates integration with Aetna programs.
• Applies clinical judgment to strategies designed to reduce risk factors and address barriers affecting care planning.
• Assessments consider information from various sources to address all conditions including co-morbidity and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member's work capacity and related restrictions/limitations.
• Refer to clinical resources for assistance in determining functionality; consults with supervisor to overcome barriers.

Skills

Bilingual (English/Spanish)

Case management experience

Strong communication skills

Education

Associate’s degree

Bachelor’s degree preferred

Tools

Microsoft Office

Job description

CVS Health is seeking a registered nurse to perform case management, coordinating care for members via telephonic and face-to-face encounters. The RN will assess medical needs, plan interventions, and coordinate with appropriate programs to improve overall wellness.

This is a full-time role with a focus on patient-centered care and collaboration with multidisciplinary teams. The position requires an active RN license, 3+ years of clinical practice, and strong communication and bilingual