CVS Health is looking for a Care Manager, Registered Nurse to join our Special Needs Plan (SNP) care team. In this remote role based in Ohio, you will coordinate care for members who often face multiple chronic medical and behavioral health conditions as well as social determinants of health needs. You'll be responsible for conducting comprehensive assessments, developing individualized care plans, and collaborating with an interdisciplinary team to ensure optimal health outcomes.
What You'll Do
- Dedicate 50-75% of your day to telephonic engagement with members and the coordination of their care.
- Compile clinical information and partner with members to develop individualized care plans with goals and interventions.
- Provide evidence-based disease management education and support to help members achieve health goals.
- Ensure the appropriate members of the interdisciplinary care team are involved in each member's care.
- Provide care coordination to support a seamless health care experience.
- Meticulously document all care management activity in the member's electronic health record.
- Collaborate with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining stable health.
- Identify and connect members with health plan benefits and community resources.
- Meet regulatory requirements within specified timelines.
- Support other Care Team members through clinical decision making and guidance.
- Participate in special projects, process improvement initiatives, or assist with mentoring new team members as assigned.
What We're Looking For
- Active and unrestricted Registered Nurse (RN) licensure in the state of Ohio OR compact licensure in your state of residence.
- Proficiency in the Microsoft Office Suite (Word, Excel, Outlook, OneNote, and Teams).
- Access to a private, dedicated workspace to conduct work effectively.
- Confidence working at home as an independent thinker, using tools to collaborate and connect with teams virtually.
- Minimum of 3+ years of nursing experience.
- Minimum of 2+ years of case management, discharge planning, and/or home healthcare coordination experience.
- An Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field.
Nice to Have
- Experience providing care management for Medicare and/or Medicaid members.
- Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.
- Experience conducting health-related assessments and facilitating the care planning process.
- Bilingual skills, especially English-Spanish.
- A Bachelor’s of Science in Nursing (BSN).
Technical Stack
- Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams)
- Healthcare technology tools
- Electronic health record systems
Team & Environment
You will be a key member of our Special Needs Plan (SNP) care team and the broader Interdisciplinary Care Team.
Benefits & Compensation
- Annual base salary range: $54,095.00 - $116,760.00
- Affordable medical plan options
- 401(k) plan with matching company contributions
- Employee stock purchase plan
- No-cost programs 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
Work Mode
This is a fully remote position requiring you to reside and be licensed in Ohio.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
