Case Manager RN

Aetna Inc. Denver , CO 80208

Posted 4 weeks ago

Job Description

This RN Case Manager position is 100% remote and candidates can apply from any state, however, preference is for candidates in CST, MST or PST time zones and with Compact RN licensure.

Normal Working Hours: Monday through Friday between the hours of 8a-6pm CST for a scheduled 8-hour shift.

Weekends may be required per the needs of the department.

Employees will have an occasional evening shift rotation per the needs of the team.

Less than 10% travel may be required for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., finger printing.

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.

RN Case Manager:

  • 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.

Pay Range

The typical pay range for this role is:

Minimum: 55,300

Maximum: 118,900

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

  • Must have an active and unrestricted RN license and, if located within the Nurse Licensure Compact jurisdiction, the ability to use their compact license without restriction

  • Willingness and ability to obtain additional state licenses upon hire (paid for by the company)

  • 3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)

  • Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time

  • A private designated workspace free of distractions and high-speed internet

Preferred Qualifications

Employee that lives in CST, MST or PST Time Zone

  • Compact RN licensure

  • 1+ years of case management experience

  • Certified Case Manager (CCM) certification

  • Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.

  • Experience with all types of Microsoft Office including PowerPoint, Excel, and Word

  • Strong telephonic communication skills

  • 1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.

  • BSN

  • Transgender certification

Education

  • Associate Degree in Nursing

Business Overview

Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.


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