CVS Health is looking for a Case Manager Registered Nurse to join our team supporting members in West Virginia. In this role, you will be a key member of our Special Needs Plan care team, coordinating care for members who often face multiple chronic health conditions and social determinants of health needs. You’ll provide compassionate, evidence-based support to help members navigate their health journey.
What You'll Do
- Spend 50-75% of your day on telephonic engagement with members and coordinating their care.
- Compile clinical information and partner with members to develop individualized care plans.
- Provide evidence-based disease management education and support to help members achieve health goals.
- Ensure the appropriate interdisciplinary care team members are involved in each member’s care.
- Provide care coordination to support a seamless healthcare experience.
- Document all care management activity meticulously 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 all regulatory requirements within specified timelines.
- Support other Care Team members through clinical decision making and guidance.
- Take on additional responsibilities as assigned to support team objectives and enhance operational efficiency.
What We're Looking For
- Active and unrestricted Registered Nurse (RN) licensure in WV OR compact licensure in your state of residence.
- Proficiency in the Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).
- Access to a private, dedicated space to conduct work effectively.
- Confidence working at home as an independent thinker, using tools to collaborate and connect with teams virtually.
- A minimum of 3+ years of nursing experience.
- A 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 healthcare-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
Team & Environment
You will be a member of the Special Needs Plan (SNP) care team and the Interdisciplinary Care Team.
Benefits & Compensation
- Annual compensation 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 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.
Work Mode
This is a remote position open to candidates located in West Virginia.
CVS Health is an equal opportunity employer. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
