Case Manager - Registered Nurse (CST)

CVS Health•Prior Lake, MS

1d•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. Position Summary 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.

Requirements

Candidate must have active and unrestricted Compact Registered Nurse (RN) License in the state of residence
Candidate must be located in Central Time Zone (CST)
3+ years clinical practical experience required
2+ years case management, discharge planning and/or home health care coordination experience
Associate's Degree in Nursing (REQUIRED)
Active and unrestricted Compact Registered Nurse (RN) License in the state of residence

Nice To Haves

preference for the following backgrounds: diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac with Medicare members
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 reimburse expense
Bilingual
Certified Case Manager
National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
Bachelor's Degree in Nursing (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.