Case Manager Registered Nurse - Medicare (Remote)

CVS Health

20h•Remote

About The Position

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. Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.

Requirements

Active and restricted RN Compact licensure.
Minimum 3+ years clinical practical experience preference: (Diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
Minimum 2+ years Case Management, discharge planning and/or home health care coordination experience.
Excellent analytical and problem-solving skills.
Effective communications, organizational, and interpersonal skills.
Ability to work independently (may require working from home).
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
Efficient and Effective computer skills including navigating multiple systems and keyboarding.
Willing and able to obtain multi state RN licenses if needed, company will provide.
Associates degree or Nursing diploma require.

Nice To Haves

Certified Case Manager is preferred.
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required.
Bachelor’s degree preferred.

Responsibilities

Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.
Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.
Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.