Case Manager Registered Nurse

CVS Health•Work At Home-Pennsylvania, PA

3d•$60,522 - $129,615•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. 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 8:30am – 5:00pm in their 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. 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.

Requirements

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.
Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.

Nice To Haves

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.
Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
Openness to learning new skills in the future as the workplace environment evolves

Responsibilities

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.