Case Manager, Registered Nurse
CVS Health
full-time
Posted on:
Location Type: Hybrid
Location: San Antonio • Texas • United States
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Salary
💰 $60,522 - $129,615 per year
About the role
- Assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness
- Developing a proactive course of action to address issues presented to enhance short- and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration
- Conducting evaluations of member’s needs and benefit plan eligibility through the use of clinical tools and information/data review
- Applying clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators impacting care planning and resolution of member issues
- Reviewing prior claims to address potential impact on current case management and eligibility
- Assessing the member’s level of work capacity and related restrictions/limitations
- Using a holistic approach to assess the need for referral to clinical resources for assistance in determining functionality
- Consulting with supervisor and others to overcome barriers in meeting goals and objectives, presenting cases at case conferences for multidisciplinary focus
Requirements
- Must have active current and unrestricted RN multistate licensure in the state where they reside
- Willingness to obtain additional state licenses will be required upon hire (expenses will be covered by company)
- 3+ years clinical practice experience as an RN required
- 1+ year(s) experience utilizing multiple computer systems and applications including Microsoft Word, Excel, Outlook, and web-based applications
- Must be able to work Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion when required to meet business needs
- Case Management in an integrated model preferred
- Bilingual in Spanish and English preferred
- Strong computer skills
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
case managementclinical judgmentrisk assessmentfunctional assessmentevaluationmedical needs assessmentbenefit plan eligibilityholistic approachmultidisciplinary focusclinical tools
Soft Skills
communicationproblem-solvingcollaborationflexibilityorganizational skillsinterpersonal skillsproactive approachconsultationgoal-orientedadaptability
Certifications
RN multistate licensure