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Experienced Remote Case Manager RN - Transforming Healthcare through Innovative Case Management in Arizona

Worldwide Salaried Open

Bringing Our Heart to Every Moment of Your Health: Join CVS Health as a Remote Case Manager RN At CVS Health, we're on a mission to revolutionize healthcare by making it more personal, convenient, and affordable. As a leader in the healthcare industry, we're committed to delivering enhanced human-centric health care solutions that cater to the evolving needs of our customers and members. Our purpose is clear: to bring our heart to every moment of your health. If you're a dedicated and compassionate Registered Nurse looking to make a meaningful impact in the lives of others, we invite you to join our team as a Remote Case Manager RN in Arizona. About Aetna One Advocacy (A1A) and the Role Aetna One Advocacy (A1A) is Aetna's premier service and clinical offering, designed to provide industry-leading solutions for our customers and members nationwide. As a Remote Case Manager RN, you'll be an integral part of this innovative model, working closely with our dedicated service and clinical pods to maximize inbound and outbound touchpoints, solve members' needs, and create behavior change. Our data analytics, white-glove service, and end-to-end ownership of member support make us a trusted partner in health.

Key Responsibilities

Telephonically and/or face-to-face assess, plan, implement, and coordinate all case management activities with members to evaluate their medical needs and facilitate overall wellness. Develop a proactive course of action to address issues presented, enhancing short and long-term outcomes and opportunities for overall wellness through integration. Conduct evaluations of members' needs and benefit plan eligibility, facilitating integrative functions and smooth transitions to Aetna programs and plans. Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers, addressing complex health and social indicators that impact care planning and resolution of member issues. Assess information from various sources to address all conditions, including co-morbid and multiple diagnoses that impact functionality. Review prior claims to address potential impacts on current case management and eligibility. Utilize case management processes in compliance with regulatory and company policies and procedures. Consult with supervisors and others to overcome barriers in meeting goals and objectives, presenting cases at case conferences for multidisciplinary focus to benefit overall claim management.

Essential Qualifications

A Registered Nurse with an unrestricted license in their state of residence, multi-state/compact privileges, and willingness to be licensed in all non-compact states. Upon hire, obtain all 50 state licenses. 3+ years of clinical practice experience as an RN. Live within a commutable distance of Chandler, Arizona (typically within 45 minutes maximum). Associate's Degree in Nursing required; BSN preferred.

Preferred Qualifications

Case Management experience in an integrated model. Certified Case Manager (CCM) certification.

Skills and Competencies

Required for Success To excel as a Remote Case Manager RN, you'll need to possess a unique blend of clinical expertise, communication skills, and analytical abilities. Key competencies include: Strong clinical judgment and decision-making skills. Excellent communication and interpersonal skills. Ability to work independently and as part of a team. Strong analytical and problem-solving skills. Proficiency in using clinical tools and software.

Career Growth

Opportunities and Learning Benefits At CVS Health, we're committed to supporting the growth and development of our employees. As a Remote Case Manager RN, you'll have access to a range of training and development opportunities, including: Comprehensive onboarding program. Ongoing training and education in case management and industry trends. Opportunities for career advancement and professional growth. Mentorship and coaching from experienced professionals.

Work Environment and Company Culture

As a Remote Case Manager RN, you'll work from home with occasional in-office workdays scheduled in advance. Our company culture is built on a foundation of empathy, innovation, and teamwork. We value diversity, equity, and inclusion, and strive to create a work environment that's inclusive and supportive.

Compensation, Perks, and Benefits

We offer a competitive salary range of $54,095.60 - $116,760.80, depending on experience, education, and other relevant factors. In addition to your compensation, you'll enjoy a range of benefits, including: Medical, dental, and vision benefits. 401(k) retirement savings plan and Employee Stock Purchase Plan. Fully-paid term life insurance plan and short-term and long-term disability benefits. Well-being programs, education assistance, and free development courses. CVS store discount and discount programs with participating partners. Paid Time Off (PTO) and paid holidays throughout the calendar year. Join Our Team and Make a Difference If you're a compassionate and dedicated Registered Nurse looking to make a meaningful impact in the lives of others, we invite you to join our team as a Remote Case Manager RN in Arizona. Apply now and become part of our mission to transform healthcare and make it more personal, convenient, and affordable. Don't miss this opportunity to join our team and make a difference in the lives of our members. Apply today! Apply for this job Apply tot his job Apply To this Job

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