Experienced Telehealth Case Manager RN - North Carolina - Remote Opportunity with Competitive Salary and Comprehensive Benefits

Join the CVS Health Team as a Telehealth Case Manager RN

About CVS Health

CVS Health is a leading healthcare company that shares a single, clear purpose: Bringing our heart to every moment of your health. Our Heart At Work Behaviors support this purpose, empowering every employee to feel empowered by their role in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.

Job Summary

The Case Manager RN role is a telework/hybrid position that requires the ability to work from home and occasionally travel to our High Point office for customer meetings. As a Case Manager RN, you will be responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate their medical needs and facilitate their overall wellness.

Key Responsibilities

• Develop a proactive course of action to address issues presented and enhance short and long-term outcomes, as well as opportunities to enhance a member's overall wellness through integration.
• Conduct evaluations of members' needs and benefit plan eligibility, and facilitate integrative functions as well as smooth transition 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.
• Assess members' needs, taking into account information from various sources, including prior claims, to address all conditions, including co-morbid and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member's level of work capacity and related restrictions/limitations.
• Using a holistic approach, assess the need for a referral to clinical resources for assistance in determining functionality.
• Consult with supervisor and others in overcoming barriers in meeting goals and objectives, and present cases at case conferences for multidisciplinary focus to benefit overall claim management.
• 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.

Requirements

Essential Qualifications

• Active and unrestricted RN license in the state of North Carolina.
• 2+ years of clinical experience as an RN, with all clinical experience considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical/Surgical, Orthopedics, Long Term Care, and Infusion nursing.

Preferred Qualifications

• Certified Case Manager (CCM) certification.
• 3+ years' experience with Microsoft Office Suite.
• Case Management experience in an integrated model.
• Discharge Planning experience.
• Managed care experience.

Education

Associates Degree in Nursing, with BSN preferred.

Work Environment and Culture

As a remote worker, you'll enjoy the flexibility and convenience of working from home, with occasional travel to our High Point office for customer meetings. Our company culture is built on our Heart At Work Behaviors, which support our purpose and empower every employee to make a positive impact. We offer a comprehensive benefits package, including:

• Competitive salary: $54,095.60 - $116,760.80 per year.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Paid Time Off (PTO) and paid holidays.
• Education assistance and free development courses.
• CVS store discount and discount programs with participating partners.

Career Growth Opportunities and Learning Benefits

At CVS Health, we're committed to helping our employees grow and develop their skills. We offer:

• Opportunities for professional growth and advancement.
• Training and development programs.
• Mentorship and coaching.
• Education assistance and tuition reimbursement.

Why Join CVS Health?

By joining CVS Health, you'll become part of a purpose-driven organization that's committed to making a positive impact on the lives of our members. We offer a comprehensive benefits package, opportunities for professional growth and development, and a company culture that's built on our Heart At Work Behaviors. If you're a compassionate and experienced RN looking for a new challenge, we encourage you to apply for this exciting opportunity.

How to Apply

If you're interested in this opportunity, please submit your application today! We value a great attitude and a willingness to learn above all, so don't hesitate to apply if you don't meet every single requirement.

Apply now and join our team as a Telehealth Case Manager RN!