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Position Summary
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.
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Normal Working Hours: Monday through Friday between the hours of 10:30am - 7:00pm EST 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.
- 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.
- Must have a private designated workspace free of distractions and high-speed internet
- 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
- 3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)
- 1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.
- 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 and organizational skills
- Excellent critical thinking skills
Associate degree required
BSN preferred
Pay Range
The typical pay range for this role is:
$54,095.60 - $116,760.80
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 11/18/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.