Case Manager Registered Nurse - Medicare (Remote)

About This Role

The Case Manager Registered Nurse - Medicare position at CVS Health involves collaborating with members, providers, and community organizations to address comprehensive health care needs. This role is ideal for experienced nurses looking to make a significant impact on community care.

Highlights

• Pay: $60,522 - $129,615/year
• Location: Remote, PA
• Schedule: Full-time, Monday-Friday 8:00am-5:00pm EST
• Residency: Must reside in the state where you have confirmed you currently live

What You'll Do

• Act as a liaison with members, employers, providers, and insurance companies.
• Implement and coordinate case management activities for catastrophic cases and chronically ill members.
• Interact with members telephonically or in person, including home visits.
• Assess and analyze medical and vocational status of members.
• Develop a plan of care to facilitate appropriate condition management.
• Communicate with stakeholders regarding member care and treatment.
• Prepare documentation of case work activities.
• Consult with internal multidisciplinary teams to maximize health outcomes.
• Provide educational and prevention information for best medical outcomes.
• Monitor member progress toward desired outcomes through assessment and evaluation.

Requirements

Education:

• Associate's degree or Nursing Diploma required
• Bachelor's degree preferred

Experience:

• Minimum 3+ years clinical practical experience preferred in diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac care with Medicare members
• Minimum 2+ years case management, discharge planning, and/or home health care coordination experience

Licenses & Certifications:

• Registered and unrestricted Compact RN licensure required
• Certified Case Manager preferred
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred

Benefits

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

About CVS Health

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on creating a more connected and compassionate health experience for individuals and communities.