Case Manager, Registered Nurse (Remote)
CVS Health- Full Time
- Junior (1 to 2 years)
Candidates must reside in Kentucky or a contiguous state, possess an active, unrestricted Registered Nurse (RN) license in Kentucky, have one or more years of maternal child nursing experience, demonstrate intermediate to advanced computer skills with Microsoft Word, Outlook, and Excel, and possess knowledge of community health and social service agencies. Applicants must also be able to travel up to 40 miles within Kentucky and maintain a valid state driver’s license with personal vehicle liability insurance meeting state minimum requirements.
The RN, Field Care Manager will assess and evaluate prenatal and postpartum members’ needs, create and maintain members’ care plans, ensure patients are progressing toward desired outcomes through assessments and evaluations, employ various strategies to manage members’ health issues, and facilitate interaction with appropriate resources for member and family wellbeing. They will also monitor changes in legislation, conduct audits, deliver training, advise management on risk mitigation, and utilize computer skills to support their duties.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.