CVS Health-posted 6 days ago
$22 - $129,615/Yr
Full-time • Mid Level
Remote • Altavista, VA
5,001-10,000 employees

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Need to reside in or near Campbell County Virginia This Case Management position is with Aetna’s Long-Term Services and Supports (LTSS) team and is a field-based position out of Charlottesville Virginia. The requirements is for candidates to hold a Virginia RN or LPN License, and travel up to 50-75% of the time to meet with members face to face. The Nurse Case Manager is responsible for evaluating and coordinating care for members to improve their overall health and wellness. This includes: Assessing medical needs and eligibility. Developing care plans to address short- and long-term health goals. Using clinical tools and data to guide decisions. Coordinating services across programs and providers. Addressing complex health and social issues. Reviewing claims and functional capacity. Referring members to appropriate clinical resources. Collaborating with supervisors and multidisciplinary teams. Ensuring compliance with policies and regulations. Engaging members through effective communication. Work Location & Travel Requirements: This is a Work-at-Home (WAH) position based out of the candidate’s residence in Campbell County VA, with up to 75% field travel. The role requires a secure, HIPAA-compliant home workspace with reliable phone and hard-wired internet service. Work hours are Monday through Friday, 8 AM to 5 PM EST. Colleagues must be accessible via phone, videoconference, and email during scheduled hours and ensure that personal responsibilities, including dependent care, do not interfere with work duties. As a field-based role, the Nurse Case Manager will regularly travel to various locations including member homes, healthcare facilities (e.g., nursing homes, rehab centers), community sites, and client or company locations. Unlike office-based roles, field-based colleagues do not have a single primary worksite and may work in multiple locations throughout the week or month.

  • Assessing medical needs and eligibility.
  • Developing care plans to address short- and long-term health goals.
  • Using clinical tools and data to guide decisions.
  • Coordinating services across programs and providers.
  • Addressing complex health and social issues.
  • Reviewing claims and functional capacity.
  • Referring members to appropriate clinical resources.
  • Collaborating with supervisors and multidisciplinary teams.
  • Ensuring compliance with policies and regulations.
  • Engaging members through effective communication.
  • Candidates must reside in or near Campbell County, VA
  • Must possess reliable transportation and be willing and able to travel up to 50-75% of the time. Mileage is reimbursed per our company expense reimbursement policy
  • LPN/RN with current unrestricted Virginia state licensure required.
  • 3 years Clinical Experience (Preferably in Medical-Surgical Nursing, Behavioral Health, Long term Care, etc.)
  • 1+ years Managed Care experience.
  • Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
  • Case Management in an integrated model preferred (Waiver and IDDP-Combination of different services)
  • Bilingual in English/Spanish
  • 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.
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service