Case Manager RN

19 hours ago


Phoenix, Arizona, United States CVS Health Full time
Job Summary

CVS Health is seeking a skilled Case Manager RN to join our team. As a Case Manager RN, you will play a critical role in coordinating and documenting all aspects of the utilization/benefit management program.

Key Responsibilities:

  • Apply critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and medical necessity criteria for members by providing care coordination, support, and education for members through the use of care management tools and resources.
  • Evaluate members' needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating members' benefit plans and available internal and external programs/services.
  • Identify high-risk factors and service needs that may impact member outcomes and care planning components with appropriate referrals.
  • Coordinate and implement assigned care plan activities and monitor care plan progress.

Requirements:

  • Active and unrestricted RN license in the state of Arizona.
  • 2+ years of clinical experience as a RN.
  • 2+ years of case management, discharge planning, and/or home healthcare experience.
  • Reliable transportation required; mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications:

  • Experience working with people who have been designated as having a serious mental illness (SMI) and experience working with people who are elderly or have a physical disability is very strongly preferred.
  • Computer proficient with MS Windows, Outlook, and Word.
  • Experience collaborating with medical professionals.
  • Strong organization and time management skills.

About CVS Health:

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.



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