Registered Nurse Case Manager - Field in Denton County Texas
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. Case Manager (RN) – Field & Telephonic Location: Denton County Texas Remote with local travel of up to 75% of the time Position Summary Nurse Case Manager (RN) for a work-from-home role that requires frequent local travel for in-home member visits and occasional visits to nursing facilities within the Denton County (Denton, Justin, Ponder, Flower Mound, Highland Village, North Lake) In this role, you will deliver high-quality case management services through a combination of telephonic and face-to-face engagement, helping members navigate their healthcare needs and achieve improved health outcomes.
Requirements
- Licensed Registered Nurse in Texas
- 3 or more years of Clinical Nursing Experience
- 1 or more years case management experience
- Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy
Nice To Haves
- Experience in a Managed Care Organization (MCO)
- STAR Kids program experience
- Bilingual (English/Spanish) preferred
- BSN Preferred
Responsibilities
- Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs
- Develop and implement individualized care plans, ensuring alignment with clinical and program guidelines
- Coordinate and monitor ongoing care plan activities, adjusting as needed to improve outcomes
- Collaborate in multidisciplinary care reviews to optimize member health results
- Identify and escalate quality of care concerns through appropriate channels
- Engage members using motivational interviewing and coaching techniques to encourage healthy lifestyle choices
- Educate and empower members to actively participate in healthcare decision-making with their providers
- Use strong negotiation and coordination skills to secure appropriate services and resources
- Ensure accurate and timely documentation, adhering to regulatory, accreditation, and company standards
- Serve as a preceptor and mentor to new nurses and clinical staff
- Support onboarding by teaching policies, workflows, and best practices
- Foster a positive, supportive learning environment that promotes clinical excellence
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
