Case Manager Registered Nurse

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.

This is a full-time telework position with less than 5% travel required.

The schedule for this role is Monday-Friday 8:30a-5p in time zone of residence.

Position Summary

This RN Case Manager position is 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. 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.

• 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.

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

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

• Must be willing and able to obtain additional state licenses as needed

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

• 1+ year(s) of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone

• 1+ year(s) of experience with all Microsoft Office Suite applications

• Must be willing and able to work Monday through Friday between the hours of 8:30am – 5:00pm in applicant's time zone 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

• Must be willing and able to travel less than 5% for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., finger printing

Preferred Qualifications

• Compact RN licensure

• 1+ year(s) 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

• Strong telephonic communication and organizational skills

• Excellent critical thinking skills

Education

• Associate's Degree required
• BSN preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $116,760.00

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 ph