Case Manager RN- Field

About the position The Nurse Case Manager at CVS Health is responsible for assessing, planning, implementing, and coordinating case management activities for members in the Northern Virginia area. This role focuses on evaluating the medical needs of members to enhance their overall wellness through a proactive approach. The position requires both telephonic and face-to-face interactions with members, utilizing clinical judgment and tools to address complex health and social indicators that impact care planning. The Nurse Case Manager will work closely with multidisciplinary teams to ensure effective case management and compliance with regulatory policies. Responsibilities • Assess and evaluate the medical needs of members telephonically and face-to-face. • Develop proactive plans to enhance short and long-term health outcomes for members. • Facilitate smooth transitions to Aetna programs and plans. • Conduct evaluations of member needs and benefit plan eligibility using clinical tools. • Utilize case management processes in compliance with regulatory and company policies. • Engage members through effective interviewing skills to discern their health status and needs. • Consult with supervisors and present cases at case conferences for multidisciplinary focus. Requirements • Current unrestricted Virginia state licensure as a Registered Nurse (RN) required. • 3+ years of clinical experience as a Registered Nurse in areas such as med surg, behavioral health, or acute care. • Willingness and ability to travel up to 75% of the time to meet members in their homes. • Proficiency with computer skills, including navigating multiple systems and keyboarding. • Effective verbal and written communication skills. Nice-to-haves • Experience in case management within an integrated model preferred. • Bilingual in English/Spanish preferred. • Ability to multitask and prioritize in a fast-paced environment. Benefits • Full range of 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 and education assistance. • 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