Case Manager, Registered Nurse
New
C
CVS HealthHealthcare
United StatesFull-TimeMiddle
Salary$60,522.00 - $129,615.00 / year
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Job Details
- Experience
- 3+ years of clinical practical experience; 2+ years of case management, discharge planning and/or home health care coordination experience
- Required Skills
- Microsoft OfficeEHR
Requirements
- Active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida.
- Associate's Degree in Nursing or Nursing Diploma.
- 3+ years of clinical practical experience (e.g., diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, Home Health) with Medicare members.
- 2+ years of case management, discharge planning, and/or home health care coordination experience.
- Proficiency with Microsoft Word, Excel, Outlook, and PowerPoint.
- Ability to work in a fast-paced, high-volume environment.
- Demonstrated time management and prioritization skills.
- Efficient computer navigation skills across multiple systems.
- Must maintain a dedicated, quiet, and private home office workspace.
- Must obtain a hardwired internet connection with at least 25 Mbps download and 3 Mbps upload speeds (WiFi/Satellite not permitted).
- Must reside in the state and city of employment.
Responsibilities
- Collaborate with members, providers, and community organizations to address health and social determinant needs.
- Perform assessment, planning, facilitation, care coordination, evaluation, and advocacy for comprehensive health needs.
- Act as a liaison between the member/client, their family, employers, providers, and insurance companies.
- Coordinate case management activities for catastrophic and chronic cases including home care visits and community resource utilization.
- Conduct telephonic or in-person assessments and develop plans of care to optimize wellness and medical outcomes.
- Prepare required documentation and consult with multidisciplinary teams to support member health outcomes.
- Apply laws, regulations, and insurance carrier instructions regarding rehabilitation services and clinical care.
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