Case Manager RN - Work From Home - PST

CVS Health • Washington, DC

2d • 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: This RN Case Manager position is 100% remote and candidates are required to live PST or MST. Compact license is preferred. Normal Working Hours: Monday through Friday 8am-5pm in time zone of residence with requirement to flex time to meet member/business needs. 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. RN Case Manager: – 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. Please note: -This role involves using a computer station with multiple screens, operating multiple programs simultaneously, and sitting for extended periods of time. - A private designated workspace free of distractions and high-speed internet is needed for this position.

Requirements

• Must have an active and unrestricted RN license in state of residence, preferably compact
• RN living in MST, or PST Time Zone
• 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)

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.

Responsibilities

• 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.

Benefits

• This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
• The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
• Additional details about available benefits are provided during the application process and on Benefits Moments.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees