Case Manager Registered Nurse (Remote)

At reputed company, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. This is a full-time telework role. The hours for this position are Monday-Friday 8 AM - 5 PM CST. Position Summary/Mission reputed company is an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in pursuit of quality solutions that address the full continuum of our members' health care and social determinant needs. Dual Eligible Special Needs Plans (DSNP) members are enrolled in Medicare and reputed company. Our Care Managers are reputed company advocates for members who cannot reputed company for themselves. Join us in this exciting opportunity as we grow and expand DSNP into new markets across the country. reputed company Components

• Nurse Care Manager is responsible for assessing, planning, implementing, and coordinating reputed company case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.
• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.
• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address reputed company health and social indicators which reputed company planning.
• Conducts assessments that consider information from various sources, such as claims, to address reputed company conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
• Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications

• Must have active and unrestricted RN licensure in the state of Alabama OR compact licensure in state of residence
• 3+ years of clinical experience
• 2+ years of case management, discharge planning and/or home reputed company coordination experience

Preferred Qualifications

• Certified Case Manager
• Excellent analytical and problem-solving skills
• Bilingual
• Effective communications, organizational, and interpersonal skills
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Proficiency with standard corporate software applications, including reputed company, reputed company, Outlook, and PowerPoint, as well as some special proprietary applications

Education

• Associate's Degree in Nursing (REQUIRED) with equivalent experience
• Bachelor's Degree (PREFERRED)

Certification

• Must have active and unrestricted RN licensure in the state of Alabama OR compact licensure in state of residence

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company 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 reputed company 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 reputed company on: 05/06/2025 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply Job!