Case Manager RN

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members from our Federal Plans. The Case Manager is responsible to evaluate the medical needs of the member in order to facilitate and promote the member’s overall wellness. The Case Manager develops a proactive course of action to address issues presented to enhance the member's short and long term outcomes.

• Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and escalate quality of care issues through established channels.
• Provide an expected very high level of customer service.
• Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.

• Must have active, current and unrestricted RN licensure in state of residence and have the ability to be licensed in all non-compact states.
• Must be willing and able to work Monday through Friday, 8 hour shift between 8am to 5:30pm Arizona time
• Must live in either PST, MST, or Arizona Time zones
• 3+ years of clinical practice experience required
• 1+ years of experience utilizing MS Office suites

• Case management experience preferred
• Case Manager Certification

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.