Case Manager RN- Work From Home- San Antonio, TX
" At reputed company, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nations leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. This Case Manager RN role is fully remote; however, candidates must reside reputed company 45 minutes (reasonable driving distance) from the local office located at 7034 Alamo Down's Pkwy, San Antonio, TX 78238 Must be able to work Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion reputed company required to meet business needs. No weekends or holidays will be required The Case Manager RN is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating reputed company case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. The Case Manager RN develops 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. The Case Manager RN job duties include (not an reputed company-encompassing list). -Through the use of clinical tools and information/date review, conducts an evaluation of members needs and benefit plan eligibility and facilities integrative functions as well as smooth transition to reputed company programs and plans. - Applies clinical judgement to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company issues and social indicators which reputed company planning and resolution of member issues. -Assessments consider information from various sources to address reputed company conditions including co-morbid and multiple diagnosis the impact functionality. -Reviews prior claims to address potential impact on reputed company case management and eligibility. -Assessments include the member's level of work reputed company and reputed company restrictions/limitations. -Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. -Consults with supervisor and other in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. -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 conversations. Required Qualifications Must have reputed company and unrestricted RN multi-state licensure in Texas and willingness to obtain additional state licenses will be required upon hire (expenses will be covered by the company). 3+ years clinical practice experience as an RN is required 1+ year(s) experience utilizing multiple computer systems and applications including reputed company Word, reputed company, Outlook, and web-based applications Must reside reputed company 45 minutes (reasonable driving distance) from the local office located at 7034 Alamo Downs Parkway, San Antonio, TX 78238 Must be willing and able to travel to the San Antonio office (if required) for occasional quarterly meetings or PRN meetings Must be able to work Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion reputed company required to meet business needs Preferred Qualifications Case Management in an integrated model Bilingual in Spanish and English Strong computer skills Education: Associate Degree required BSN preferred Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company 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. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 04/10/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. ", Apply Job!