Case Manager Registered Nurse - Medicare

Job Title: Case Manager Registered Nurse - Medicare (Remote)

Job Location: Work at Home, Pennsylvania, United States

Job Location Type: Remote

Job Contract Type: Full-time
Job Seniority Level:

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

Work Schedule: Monday-Friday 8:00am-5:00pm EST

Program Overview

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.

Family Summary/Mission

Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.

Position Summary

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.

Required Qualifications

- Active and unrestricted RN Compact licensure .

- Minimum 3+ years clinical practical experience preference: (Diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.

- Minimum 2+ years Case Management, discharge planning and/or home health care coordination experience.

​ Preferred Qualifications

- Excellent analytical and problem-solving skills.

- Effective communications, organizational, and interpersonal skills.

- Ability to work independently (may require working from home).

- 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.

- Willing and able to obtain multi state RN licenses if needed, company will provide.

- Certified Case Manager is preferred.

- Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required.

Education

- Associates degree or Nursing diploma require.

- Bachelor’s degree preferred.

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 abov