Job Description
Job Description
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.
Normal Working Hours: Monday through Friday between the hours of 10:30am - 7:00pm EST (7:30am-4pm PST) 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.
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 members overall wellness through integration.
- Through the use of clinical tools and information/data review (e.g., assessments, claims, etc.) conducts an evaluation of members 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.
Pay Range
The typical pay range for this role is:
Minimum: 55,300
Maximum: 118,900
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
- A Registered Nurse that must hold an unrestricted license in their state of residence, with multi-state/compact privileges and have the ability to be licensed in all non-compact states.
- 3+ years of acute care clinical experience as an RN required (general medical, post-surgical, specialty including pediatrics, ICU, case management and/or discharge planning).
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
- Compact RN licensure preferred.
- 1+ year(s) of case management experience preferred.
- Certified Case Manager (CCM) certification preferred.
- 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.
Education
- Associates in nursing is required; BSN preferred.
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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