Case Manager RN - Work From Home - PST

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

This RN Case Manager position is 100% remote and candidates can apply from any state. Normal Working Hours: Monday through Friday 8am-5pm in time zone of residence with requirement to flex time to meet member/business needs. It is required to have an RN who lives in either MST or PST time zone. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.

Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Through the use of clinical tools and information/data review (e.g., assessments, claims, etc..) conducts an evaluation of member’s needs and available benefits to collaborate and refer to programs offered by the plan sponsor. Applies clinical judgment to reduce risk factors, address complex health issues and social indicators. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Please note: This role involves using a computer station with multiple screens, operating multiple programs simultaneously, and sitting for extended periods of time. A private designated workspace free of distractions and high-speed internet is needed for this position.