Experienced RN Case Manager for Remote Health Care Management - North Carolina

Transforming Health Care with CVS Health: Join Our Team as a Remote RN Case Manager

At CVS Health, we're on a mission to redefine the health care experience, making it more personal, convenient, and affordable. As a leader in the health care industry, we're committed to delivering innovative solutions that cater to the evolving needs of our customers and members. Our Aetna One Advocacy (A1A) division is at the forefront of this transformation, providing industry-leading services that integrate population health and customer service for large plan sponsors.

We're seeking an experienced and compassionate RN Case Manager to join our A1A team in a remote capacity, based in North Carolina. As a Remote RN Case Manager, you'll play a vital role in assessing, planning, and coordinating case management activities to enhance the overall wellness of our members. This is an exceptional opportunity to leverage your clinical expertise, make a meaningful impact on people's lives, and grow your career within a dynamic and supportive organization.

About Aetna One Advocacy (A1A)

A1A is Aetna's premier service and clinical offering, designed to provide comprehensive support to our members through a unique blend of high-touch and high-tech advocacy. Our team combines data-driven insights with the expertise of highly trained clinical professionals and concierge member services to deliver personalized care and support. As an RN Case Manager within A1A, you'll be an integral part of this innovative model, working closely with members, health care providers, and other stakeholders to address complex health needs and improve outcomes.

Key Responsibilities

• Conduct comprehensive assessments of members' medical needs, using clinical tools and data review to inform care planning and coordination.
• Develop and implement proactive case management plans to address member needs, reduce risk factors, and enhance overall wellness.
• Utilize clinical judgment to incorporate strategies that address complex health and social indicators, promoting smooth transitions to Aetna programs and plans.
• Collaborate with supervisors and other stakeholders to overcome barriers, present cases at multidisciplinary conferences, and drive effective claim management.
• Apply case management processes in compliance with regulatory requirements and company policies, ensuring seamless coordination of care.
• Leverage interviewing skills to engage members, discern their health status and needs, and provide personalized support.

Essential Qualifications

• Current, unrestricted RN license in your state of residence, with multi-state/compact privileges and willingness to obtain licensure in all non-compact states.
• 3+ years of clinical practice experience as an RN, with a strong foundation in case management principles.
• Residency within commutable distance of High Point, North Carolina (typically within 45 minutes maximum).
• Associate's Degree in Nursing; BSN preferred.

Preferred Qualifications

• Case Management experience in an integrated model.
• Certified Case Manager (CCM) certification.

Skills and Competencies

To succeed as an RN Case Manager at CVS Health, you'll need to possess a unique blend of clinical expertise, communication skills, and analytical abilities. Key competencies include:

• Strong clinical judgment and decision-making skills.
• Excellent communication and interpersonal skills, with ability to engage members and stakeholders.
• Analytical and problem-solving skills, with ability to interpret data and drive informed care planning.
• Ability to work in a fast-paced, dynamic environment, with flexibility to adapt to changing priorities.

Career Growth and Development

At CVS Health, we're committed to supporting the growth and development of our colleagues. As an RN Case Manager, you'll have access to a range of training and development opportunities, including:

• Comprehensive onboarding and training program.
• Ongoing professional development and continuing education opportunities.
• Career advancement opportunities within Aetna and CVS Health.

Work Environment and Culture

As a Remote RN Case Manager, you'll work from home, with occasional in-office workdays scheduled in advance. Our culture is built on a foundation of empathy, innovation, and collaboration, with a focus on delivering exceptional care and support to our members. We offer a range of benefits and perks, including:

• Competitive salary and bonus structure.
• Comprehensive benefits package, including medical, dental, and vision coverage.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Paid Time Off (PTO) and holidays.
• Well-being programs, education assistance, and free development courses.
• CVS store discount and discount programs with participating partners.

Compensation and Benefits

The typical pay range for this role is $54,095.60 - $116,760.80, with a competitive salary and bonus structure. We're committed to providing a comprehensive benefits package that supports the well-being and financial security of our colleagues.

Join Our Team

If you're a compassionate and experienced RN looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Remote RN Case Manager at CVS Health, you'll be part of a dynamic team that's transforming the health care experience. With a focus on innovation, empathy, and collaboration, we're committed to delivering exceptional care and support to our members. Apply now and join our mission to redefine health care.

Apply by January 31, 2025, to be considered for this opportunity.