CVS Health is looking for a Case Manager, Registered Nurse to be a key member of our Special Needs Plan (SNP) care team. You will coordinate care for members who often face multiple chronic medical and behavioral health conditions and various social determinants of health needs, ensuring a connected and compassionate health care experience.
What You'll Do
- Dedicate 50-75% of your day to telephonic engagement with members and care coordination.
- Compile clinical information and partner with members to develop individualized care plans.
- Provide evidence-based disease management education and support.
- Ensure the appropriate interdisciplinary care team members are involved.
- Provide care coordination to support a seamless health care experience.
- Document all care management activity meticulously in the member’s electronic health record.
- Collaborate with the Interdisciplinary Care Team to address care barriers and maintain member stability.
- 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 mentor new team members as assigned.
What We're Looking For
- Active and unrestricted Registered Nurse (RN) licensure in Ohio or compact licensure in state of residence.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).
- Access to a private, dedicated workspace.
- Confidence working independently from home and collaborating virtually.
- 3+ years of nursing experience.
- 2+ years of case management, discharge planning, and/or home healthcare coordination experience.
- An Associate’s of Science in Nursing (ASN) degree.
Nice to Have
- Experience providing care management for Medicare and/or Medicaid members.
- Experience working with individuals with SDoH needs, chronic 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)
Team & Environment
You will be a member of the Special Needs Plan (SNP) care team and the Interdisciplinary Care Team.
Benefits & Compensation
- Compensation: $54,095.00 - $116,760.00
- Affordable medical plan options.
- 401(k) plan with matching company contributions.
- Employee stock purchase plan.
- No-cost wellness screenings, tobacco cessation and weight management programs.
- No-cost 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 remote position that requires you to be located in Ohio.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
