Case Manager RN, CVS Health

CVS Health

Location:

United States, San Antonio

Category:

Health and Beauty

Contract Type:

Employment contract

Salary:

60522.00 - 129615.00 USD / Year

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Job Description:

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.

Job Responsibility:

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 the member's overall wellness
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
conducts an evaluation of members needs and benefit plan eligibility and facilities integrative functions as well as smooth transition to Aetna programs and plans
applies clinical judgement to the incorporation of strategies designed to reduce risk factors and barriers and address complex issues and social indicators which impact care planning and resolution of member issues
reviews prior claims to address potential impact on current case management and eligibility
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

Requirements:

Must have current 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 Microsoft Word, Excel, Outlook, and web-based applications
Must reside within 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 when required to meet business needs

Nice to have:

Case Management in an integrated model
Bilingual in Spanish and English
Strong computer skills

What we offer:

Affordable medical plan options
401(k) plan (including matching company contributions)
employee stock purchase plan
no-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
paid time off
flexible work schedules
family leave
dependent care resources
colleague assistance programs
tuition assistance
retiree medical access

Additional Information:

Job Posted:

March 29, 2025

Expiration:

April 10, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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