Case Manager

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary:

This RN Case Manager position is 100% remote and candidates can apply from any state but must work the stated hours.

There is a preference for nurses in a compact RN licensure state, however, that is not required.

Normal Working Hours: Monday through Friday between the hours of 0900am – 5:30pm EST for a scheduled 8-hour shift.

Weekends and holidays may be required per the needs of the department. Currently, both weekends and holidays are on-call only and covered on a volunteer basis.

Less than 5% travel may be required for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., finger printing.

The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.

RN Case Manager:

– Collaboratively 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 integration.

– Through the use of clinical tools and information/data review (e.g., assessments, claims, etc.) conducts an evaluation of member’s needs and available benefits to collaborate and refer to programs offered by the plan sponsor.

– Applies clinical judgment to reduce risk factors, address complex health issues and social indicators.

– Utilizes case management processes in compliance with regulatory and company policies and procedures.

– Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Required Qualifications:

- Must have an active current and unrestricted RN license in state of residence. If located within the Nurse Licensure Compact jurisdiction, the ability to use their compact license without restriction

- Willingness and ability to obtain additional state licenses upon hire (paid for by the company)

- 3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)

- Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time

- A private designated workspace free of distractions and high-speed internet

Preferred Qualifications:

- Compact RN licensure

- 1+ years of case management experience

- Certified Case Manager (CCM) certification

- Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.

- Experience with all types of Microsoft Office including PowerPoint, Excel, and Word

- Strong telephonic communication skills

- 1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.

Education:

- Associates Degree in Nursing required.

- Bachelor’s in Science and Nursing preferred.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.