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CVS Health logo
CVS Health

CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca

Case Manager, Registered Nurse - Remote

Location

United States

Posted

106 days ago

Salary

$60.5K - $129K / year

No structured requirement data.

Job Description

Case Manager, Registered Nurse - Remote

CVS Health

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Information Schedule: Monday–Friday 8:00am-5:00pm EST Location: 100% Remote (U.S. only) Position Summary Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes. Key Responsibilities - Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate. - Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. - Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services. - Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. - Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person. - Prepares all required documentation of case work activities as appropriate. - Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes. - May make outreach to treating physician or specialists concerning course of care and treatment as appropriate. - Provides educational and prevention information for best medical outcomes. - Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. - Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. - Utilizes case management processes in compliance with regulatory and company policies and procedures. - Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work. - Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration. - Monitors member/client progress toward desired outcomes through assessment and evaluation. Remote Work Expectations - This is a 100% remote role; candidates must have a dedicated workspace free of interruptions. - Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Required Qualifications - Active unrestricted state Registered Nurse Compact licensure in state of residence required or prior to the hire date. - 3 years clinical practical experience preference: (Adult Diabetes, CHF, CKD, Post-acute care, Hospice, Palliative care, Cardiac, Home Health) with Medicare members. - 2 years Case Management/Care Manager, discharge planning and/or Home Health care coordination experience. - Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. - Efficient and Effective computer skills including navigating multiple systems and keyboarding. - Able to work in a fast paced high volume environment and utilize time management and prioritization skills. - Commitment to attend a mandatory 3-week training (Monday–Friday, 8:30am–5:00pm EST) with 100% participation. Preferred Qualifications - Active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, South Carolina, Tennessee, Virginia, or Florida. - Bilingual preferred - Spanish - Excellent analytical and problem-solving skills. - Effective communications, organizational, and interpersonal skills. - Certified Case Manager is preferred. - Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required. - Bachelor’s degree preferred. Education - Associate's degree or Nursing Diploma required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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OtherRemoteTeam 10,001+Since 1884H1B No Sponsor

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $20.94 - $33.59Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 9:30am - 6pm Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5492 Patient Access Center Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. 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Job Closed

Director, Patient Access

Carrum Health

Carrum Health is a healthcare company that partners with employers to provide employees access to high-quality medical care through a network of top providers. Carrum Health aims t

At Carrum, we are transforming how we pay for, deliver and experience healthcare. If you are passionate about changing healthcare and want to finally get rid of surprise bills, poor quality, and high prices, while thriving in an entrepreneurial, cutting-edge environment, we would love to connect with you. In 2014 Carrum reinvented the Centers of Excellence (COE) category in digital health. Today, 95% of the US population lives within 50 miles of a Carrum COE and our providers rank in the top 10% nationally. Our team’s execution has been recognized by the venture community and we’ve raised more than $96M in aggregate from investors like OMERS, Tiger Global Management and Wildcat Ventures. Our impact has been externally proven in a 2021 RAND Corporation study and featured as a Harvard Business School (HBS) case study. We are looking for a Director of Patient Access to lead, scale, and modernize our high-volume patient engagement operations. 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United States
Job Closed
rockITdata logo

Contact Center Care Advocate

rockITdata

Experts in contact center solutions. Your product doesn’t differentiate you, but your customer support experience does.

OtherRemoteTeam 11-50H1B No Sponsor

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United States