Rn Jobs in Port St Lucie

About The Position

Requirements

• Active Illinois RN licensure; the employee does not need to live in Illinois.
• At least 2 years of clinical experience as an RN.
• An associate’s degree in nursing is the minimum education requirement.
• Ability to meet the stated work-from-home requirements, including a hardwired internet connection with the specified minimum speeds and a quiet, secure, private workspace.
• Comfort setting up and using multiple monitors and navigating multiple applications simultaneously.
• Ability to communicate through email, calendar invites, Teams messaging, and virtual meetings.
• Experience with Microsoft Office 365 applications or similar tools such as Google Workspace.
• Ability to access secure systems, follow basic security practices, and troubleshoot common technical issues.
• Openness to learning new skills as the workplace environment evolves.

Nice To Haves

• At least 1 year of case management experience.
• Compact RN licensure, or willingness and ability to obtain multiple state RN licenses after hire; company-paid expenses.
• Certified Case Manager (CCM) certification.
• Strong telephonic communication skills.
• Bachelor of Science in Nursing (BSN).

Responsibilities

• Develop proactive courses of action to address issues and improve members’ short- and long-term outcomes and overall wellness.
• Evaluate member needs and benefit-plan eligibility using clinical tools and information or data review, and facilitate integration and transitions to Aetna programs and plans.
• Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators affecting care planning and resolution of member issues.
• Assess members using information from multiple sources, considering all conditions, co-morbidities, multiple diagnoses, and their impact on functionality.
• Review prior claims for potential impact on current case management and eligibility.
• Assess members’ work capacity and related restrictions or limitations.
• Use a holistic approach to assess whether referrals to clinical resources are needed to help determine functionality.
• Consult with supervisors and others to overcome barriers to goals and objectives, and present cases at case conferences for multidisciplinary review.
• Use case management processes in compliance with regulatory requirements and company policies and procedures.
• Use interviewing skills to engage members and determine their health status and needs through key questions and conversation.
• Use multiple monitors and applications, digital communication tools, collaboration and scheduling applications, and secure systems; troubleshoot common technical issues.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources supporting colleagues’ physical, emotional, and financial well-being, based on eligibility.
• Eligibility for a CVS Health bonus, commission, or short-term incentive program in addition to base pay.