Case Manager, RN

Description:

The Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members from our Federal Plans.Evaluate the medical needs of the member in order to facilitate and promote the member’s overall wellness.Develop a proactive course of action to address issues presented to enhance the member’s short and long term outcomes.Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.Conduct comprehensive clinical assessments.Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.Advocate for patients to the full extent of existing health care coverage.Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.Identify and escalate quality of care issues through established channels.Provide an expected very high level of customer service.Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.

Requirements:

Must have active, current and unrestricted RN licensure in state of residence and have the ability to be licensed in all non-compact states.Must be willing and able to work Monday through Friday, 8 hour shift between 7am to 5pm Arizona timeMust live in either PST, MST, or Arizona Time zones3+ years of clinical practice experience required1+ years of experience utilizing MS Office suitesCase management experience preferredCase Manager CertificationAssociate’s degree requiredBSN preferred

Benefits:

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