Case Manager RN- Afternoon shift
Posted 2025-10-26
Remote, USA
Full Time
Immediate Start
About the position Responsibilities • Telephonically and/or face-to-face assess, plan, implement, and coordinate all case management activities with members. • Develop proactive courses of action to enhance short and long-term outcomes for members. • Conduct evaluations of member needs and benefit plan eligibility using clinical tools and data review. • Apply clinical judgment to reduce risk factors and address complex health and social indicators. • Review prior claims to assess their impact on current case management and eligibility. • Assess members' work capacity and related restrictions/limitations. • Utilize a holistic approach to determine the need for referrals to clinical resources. • Consult with supervisors and present cases at case conferences for multidisciplinary focus. • Utilize case management processes in compliance with regulatory and company policies. • Engage members through effective interviewing skills to discern their health status and needs. Requirements • Active current and unrestricted RN licensure in the state of residence. • Willingness to obtain multiple state RN licensure after hire (expenses paid by company). • 2+ years as an RN with med/surge experience, Emergency Department, and Telemetry. • Willingness to work Monday - Friday 9:00 am - 5:30 pm. • Willingness to work late shift once per quarter until 9 pm. • 1+ year experience with Microsoft Office including PowerPoint, Excel, and Word. Nice-to-haves • 2+ years of Case Management experience. • Strong telephonic communication skills. • Certified Case Manager (CCM) certification. Benefits • Medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays. Apply tot his job Apply To this Job