Case Manager, Registered Nurse - Work from Home - Remote

Overview

This is a remote work from home role for a Case Manager, Registered Nurse at CVS Health, focusing on providing medical management services and supporting patient care.

In Short

• Work remotely from anywhere in the US with virtual training.
• Full-time position with a shift schedule of 8:30am - 5pm.
• Engage with patients and care teams as a telephonic case manager.
• Apply clinical judgment and guidelines to assess patient needs.
• Utilize case management processes in compliance with regulations.
• Consult with clinical colleagues to overcome care barriers.
• Employ motivational interviewing to enhance member engagement.
• Identify and escalate member needs appropriately.
• Perform medical necessity reviews.
• Collaborate with multidisciplinary teams for effective care management.

Requirements

• 5+ years of experience as a Registered Nurse.
• Active, unrestricted RN license in state of residence.
• 1+ years of experience in Oncology, Transplant, Pediatrics, or Medical/Surgical.
• 1+ years of electronic documentation experience.
• 1+ years of Case Management or discharge planning experience preferred.
• Experience with Utilization Review is a plus.
• CCM or other URAC recognized accreditation preferred.
• Bilingual in Spanish is preferred.
• Diploma or Associate's Degree in Nursing required; BSN preferred.
• Willingness to receive multi-state/compact privileges.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with company matching contributions.
• Employee stock purchase plan.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and dependent care resources.
• Retiree medical access.
• Colleague assistance programs.
• Eligibility for bonuses and incentives.
• Commitment to workplace diversity and employee well-being.