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Registered Nurse Case Manager
2 months ago
About CVS Health
At CVS Health, we are dedicated to enhancing the health and well-being of our communities. Our mission is to provide personalized health care solutions that adapt to the evolving needs of our members.
Position Overview
This role is a full-time remote position requiring residency in West Virginia. The Case Manager RN will engage in up to 50% travel within the western region of the state, visiting various community locations such as member residences, treatment facilities, and other relevant sites.
Work Schedule
The standard working hours are Monday to Friday, from 8 AM to 5 PM, with no evening, weekend, or holiday shifts. After six months of satisfactory performance, a flexible schedule may be considered.
Key Responsibilities
- Conduct in-person assessments and evaluations of members' health needs.
- Utilize clinical tools to determine eligibility for benefits and facilitate transitions to appropriate programs.
- Apply clinical judgment to develop strategies that address health risks and barriers affecting care.
- Analyze information from multiple sources to manage complex health conditions.
- Review historical claims to inform current case management practices.
- Employ a holistic approach to assess the need for referrals to additional clinical resources.
- Collaborate with management and multidisciplinary teams to overcome challenges in achieving care objectives.
- Adhere to case management processes in compliance with regulatory standards.
- Engage members effectively through strong communication skills.
- Demonstrate the ability to manage multiple tasks in a dynamic environment.
Qualifications
- Must reside in the designated region of West Virginia.
- Travel is required, with a focus on community-based locations.
- Must have reliable transportation, with mileage reimbursement available.
- Current, unrestricted RN license in West Virginia or multi-state privilege.
- A minimum of five years of clinical experience is required.
- Proficiency in using computers and MS Office applications is essential.
Preferred Qualifications
- Experience with pediatric and adolescent populations.
- Familiarity with Medicaid and waiver programs.
- Background in crisis intervention and managed care.
- Certification as a Case Manager (CCM) is advantageous.
- Experience in integrated case management models.
Education Requirements
- Associate degree in nursing or equivalent nursing diploma is required.
- Bachelor's degree in nursing (BSN) is preferred.
Compensation and Benefits
The compensation for this position is competitive and includes a range of benefits such as medical, dental, and vision coverage, retirement savings plans, and various well-being programs. Employees are also eligible for paid time off and other time-off benefits in accordance with company policies.
CVS Health is committed to fostering an inclusive environment and is an equal opportunity employer.
