RN Case Manager

We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.

This RN Case Manager position is 100% remote and candidates can apply from any state but must work the stated hours.

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.

Responsibilities:

• Collaboratively develop a proactive course of action to address issues presented to enhance short- and long-term outcomes, as well as opportunities to enhance a member's overall wellness through integration.
• Conduct an evaluation of a member's needs and available benefits to collaborate and refer to programs offered by the plan sponsor.
• Apply clinical judgment to reduce risk factors, address complex health issues, and social indicators.
• Utilize case management processes in compliance with regulatory and company policies and procedures.
• Utilize interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications:

• Active current and unrestricted RN license in the state of residence.
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company).
• 3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management, and discharge planning).
• Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time.
• A private designated workspace free of distractions and high-speed internet.

Preferred Qualifications:

• Compact RN licensure.
• 1+ year 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 skills.
• 1+ year of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.

Education:

• Associate's Degree in Nursing required.
• Bachelor's Degree in Science & Nursing preferred.

Work from Home Requirements:

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer and a minimum download speed of 25 mbs download and 3 mbs upload.
• A quiet, secure, and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.

Technical and Logistical Requirements:

• Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
• Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
• Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
• Ability to log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
• Ability to resolve common technical issues independently.

Anticipated Weekly Hours: 40 Time Type: Full-time Pay Range: $60,522.00 - $129,615.00

Benefits:

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs, and other resources.