Experienced Full Time Remote Case Manager Registered Nurse - North Carolina

Introduction to CVS Health

At CVS Health, we are driven by a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. As a leader in the healthcare industry, we are dedicated to transforming the way healthcare is delivered, making it more personal, convenient, and affordable for all.

Our Heart At Work Behaviors

Our Heart At Work Behaviors support this purpose and empower everyone who works at CVS Health to feel valued and play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions. We believe that by living these behaviors, we can create a workplace where everyone feels empowered, valued, and supported to do their best work.

Job Summary

We are seeking an experienced and compassionate Registered Nurse to join our team as a Full Time Remote Case Manager in North Carolina. As a Case Manager RN, you will be responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate their medical needs and facilitate their overall wellness. This is a unique opportunity to make a meaningful difference in the lives of our members and contribute to the success of our organization.

Key Responsibilities

• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration.
• Conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assesses member's level of work capacity and related restrictions/limitations and uses a holistic approach to assess the need for a referral to clinical resources for assistance in determining functionality.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives and presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• Utilizes case management processes in compliance with regulatory and company policies and procedures and utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Essential Qualifications

To be successful in this role, you will need:

• An active and unrestricted RN license in the state of North Carolina.
• Multiple State RN licensure is welcomed but not required. If chosen, you must be willing and able to obtain multiple state RN licensure after hire (expenses paid for by the company).
• 2+ years of clinical experience as an RN - all clinical experience will be considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical / Surgical, Orthopedics, Long Term Care, and Infusion nursing.

Preferred Qualifications

While not required, the following qualifications are preferred:

• Certified Case Manager (CCM) certification.
• 3+ years' experience with Microsoft Office Suite.
• Case Management in an integrated model.
• Discharge Planning experience.
• Managed care experience.

Education

An Associate's Degree in Nursing is required, and a BSN is preferred.

Pay Range

The typical pay range for this role is $54,095.60 - $116,760.80. 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 above.

Benefits

In addition to your compensation, you will enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year.

Career Growth Opportunities

At CVS Health, we are committed to helping our employees grow and develop in their careers. We offer a range of training and development programs, including leadership development, clinical education, and professional certification programs. Our goal is to help you achieve your career goals and make a meaningful contribution to our organization.

Work Environment and Company Culture

Our work environment is dynamic, supportive, and inclusive. We believe in fostering a culture of diversity, equity, and inclusion, where everyone feels valued and respected. Our company culture is built on a foundation of integrity, respect, and compassion, and we are committed to making a positive impact on the communities we serve.

How to Apply

If you are a motivated and compassionate Registered Nurse looking for a new challenge, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to be considered for this role. We look forward to hearing from you!

We Want to Hear From You!

If this role sounds like a perfect fit, don't hesitate. Apply today and let's build the future together. We are an equal opportunity employer and welcome applications from qualified candidates. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.