Case Manager RN Oncology - Work from Home
Job Description: | 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.
Position Summary This is a remote work from home role anywhere in the US with virtual training. – Shift is 8:30 am to 5 pm in your time zone.
– This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients – Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits – Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues – Assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality – Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management – Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives – Utilizes case management processes in compliance with regulatory and company policies and procedures – Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversations – Identifies and escalates member’s needs appropriately following set guidelines and protocols – Need to actively reach out to members to collaborate/guide their care – Perform medical necessity reviews |
Job Requirements: |
– 5+ years’ experience as a Registered Nurse with hospital experience; in the specialty of oncology. – A Registered Nurse that holds an unrestricted license in their state of residence, with multi-state/compact privileges and can be licensed in all non-compact states – 1+ years’ experience documenting electronically using keyboard and multiple computer screens as well as free form text with good typing skills – 1+ years’ current or previous experience in Oncology, Behavioral Health/Substance Abuse, Transplant or Medical/Surgical Preferred Qualifications – 1+ years’ Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well as experience with transferring patients to lower levels of care – CCM and/or other URAC recognized accreditation preferred – 1+ years’ experience with MCG, NCCN and/or Lexicomp Education – Associates required – Bachelors preferred
Pay Range The typical pay range for this role is:
$54,095.60 – $116,800.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution. |
Salary: | $54,095.60 – $116,800.00 |
URL: | Apply Now |
ID: | JOB-16842 |
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