Case Manager, Registered Nurse (Remote)
CVS Health- Full Time
- Junior (1 to 2 years)
Candidates must possess a Bachelor of Science in Nursing (BSN), CCM certification or eligibility with 5+ years of experience in nursing, and 2+ years of experience in care management. They must reside in a compact NLC state and hold an active Compact RN license in good standing. Willingness to obtain and maintain licensure in multiple states is required, along with experience working remotely and competence in using multiple computer/medical record systems. Spanish speaking skills are desirable.
As a Nurse Care Manager, responsibilities include delivering coordinated, patient-centered virtual Care Management by telephone or video, creating impactful care plans with members and a diverse care team, helping members navigate complex medical conditions and the healthcare system, partnering with local providers, providing compassionate longitudinal follow-up care, assisting throughout acute healthcare episodes, coordinating necessary resources, and supporting members through complex care management, disease management, and acute case management to ensure excellent health outcomes. The role also involves communicating with colleagues and patients, gathering clinical histories, answering questions at a patient level, summarizing findings, writing medical information in patient-centric language, and strictly following security and HIPAA regulations.
Healthcare advocacy and specialized care services
Included Health focuses on enhancing the healthcare experience for individuals who often face challenges in accessing quality care. The company provides a variety of services, including primary care, behavioral health, and virtual care, ensuring that members receive timely and appropriate treatment. Their model emphasizes 24/7 on-demand care with a diverse group of providers, allowing for personalized support tailored to complex health needs. Unlike many competitors, Included Health prioritizes underserved populations and partners with employers and consultants to deliver comprehensive healthcare solutions that not only improve health outcomes but also help reduce costs. The ultimate goal of Included Health is to make quality healthcare accessible and understandable for everyone, particularly those who have been overlooked by traditional healthcare systems.