Registered Nurse Case Manager

March 24

🥔 Idaho – Remote

Although this job is listed in Idaho, this company may be open to hiring remote in other states.

🌪️ Oklahoma – Remote

Although this job is listed in Oklahoma, this company may be open to hiring remote in other states.

+1 more states

🥔 Idaho – Remote 🌪️ Oklahoma – Remote 🎸 Mississippi – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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CVS Health

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CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• Remote work from home role anywhere in the US with virtual training. • Shift schedule is 8:30am - 5pm within time zone of residence. • This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients. • Application and/or interpretation of applicable criteria and clinical guidelines, • Utilizing case management processes in compliance with regulatory and company policies and procedures. • Identifies and escalates member’s needs appropriately following set guidelines and protocols.

🎯 Requirements

• 5+ years’ experience as a Registered Nurse with at least 1 year of experience in a hospital setting, • A Registered Nurse that holds an active, unrestricted license in their state of residence, • Willingness to receive a multi-state/compact privileges and can be licensed in all non-compact states, • 1+ years’ current or previous experience in Pediatric, Oncology or Transplant, • 1+ years’ experience documenting electronically using a keyboard, • 1+ years’ Case Management experience or discharge planning, • 1+ years' experience in Utilization Review, • CCM and/or other URAC recognized accreditation preferred, • 1+ years’ experience with MCG, NCCN and/or Lexicomp, • Bilingual in Spanish preferred.

🏖️ Benefits

• Affordable medical plan options, • 401(k) plan (including matching company contributions), • Employee stock purchase plan, • No-cost programs for all colleagues including wellness screenings, • Tobacco cessation and weight management programs, • Confidential counseling and financial coaching, • 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.