Experienced Remote Case Manager Registered Nurse - Telephonic Case Management for Enhanced Member Wellness

Transforming Healthcare through Innovation and Teamwork at CVS Health At CVS Health, we're revolutionizing the way healthcare is delivered by putting our heart into every moment of your health. As a leader in the healthcare industry, we're committed to making healthcare more personal, convenient, and affordable. Our culture is built on a foundation of innovation, teamwork, and a passion for delivering exceptional care. We're now seeking an experienced Remote Case Manager Registered Nurse to join our team and play a vital role in enhancing the wellness of our members. About the Role This remote case manager RN position is based in select locations in the United States and offers a unique opportunity to work from home while making a meaningful impact on the lives of our members. As a Nurse Case Manager, you will be responsible for telephonically assessing, planning, implementing, and coordinating case management activities to evaluate the medical needs of our members and facilitate their overall wellness. Key Responsibilities Develop a proactive course of action to address member issues and enhance short and long-term outcomes, as well as opportunities to improve overall wellness through integration. Conduct comprehensive assessments of member needs, benefit plan eligibility, and facilitate integrative functions, as well as smooth transitions to Aetna programs and plans. Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers, and address complex health and social indicators that impact care planning and resolution of member issues. Utilize clinical tools and information/data review to evaluate member needs and identify opportunities for improvement. Consult with supervisors and other stakeholders to overcome barriers in meeting goals and objectives, and present cases at case conferences to benefit overall medical management. Utilize case management processes in compliance with regulatory and company policies and procedures, and employ effective interviewing skills to ensure maximum member engagement. Essential Qualifications 3+ years of clinical practice experience RN with current unrestricted state licensure Compact state licensure Willingness and ability to obtain additional state licensure as needed Associate degree required; BSN preferred Preferred Qualifications Bilingual English/Spanish Managed care experience Case management experience Skills and Competencies To succeed in this role, you will need to possess strong clinical judgment, effective communication and interviewing skills, and the ability to work independently in a remote setting. You should also be able to analyze complex health and social indicators, identify opportunities for improvement, and develop proactive plans to address member needs. Career Growth Opportunities and Learning Benefits At CVS Health, we're committed to helping our employees grow and develop in their careers. As a Remote Case Manager RN, you will have access to a range of training and development programs, including free development courses and education assistance. You will also have opportunities to advance in your career and take on new challenges. Work Environment and Company Culture As a remote employee, you will work from home and enjoy a flexible schedule that allows you to balance your work and personal life. Our company culture is built on a foundation of innovation, teamwork, and a passion for delivering exceptional care. We value diversity, equity, and inclusion, and strive to create a work environment that is inclusive and supportive. Compensation and Benefits The typical pay range for this role is $54,095.60 - $129,615.20, depending on experience, education, geography, and other relevant factors. In addition to your compensation, you will enjoy a range of benefits, including: Medical, dental, and vision benefits 401(k) retirement savings plan Employee Stock Purchase Plan Fully-paid term life insurance plan Short-term and long-term disability benefits Well-being programs and education assistance CVS store discount and discount programs with participating partners Paid Time Off (PTO) and paid holidays Why Join CVS Health? At CVS Health, we're committed to making a positive impact on the lives of our members, customers, and colleagues. As a Remote Case Manager RN, you will play a vital role in enhancing the wellness of our members and contributing to our mission to make healthcare more personal, convenient, and affordable. If you're a motivated and compassionate healthcare professional looking for a new challenge, we encourage you to apply for this exciting opportunity. Even if you feel you're not a perfect match, we'd still love to hear from you. We're looking for great people to join our friendly team and contribute to our mission. Apply today and take the first step towards a rewarding career with CVS Health! We anticipate the application window for this opening will close on: 12/13/2024. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. Apply for this job