Case Manager, Registered Nurse - Field (reputed company, Clermont, reputed company Counties)

At reputed company, 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 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. Position Summary This is a full-time telework positions requiring 50-75% travel in either reputed company County, Clermont County, or reputed company County. Applicants must reside in reputed company, Clermont, or reputed company County. Hours for these positions are Monday through Friday 8:00 AM -5:00 PM Eastern Standard Time (EST). We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Case Management team. This opportunity offers a competitive salary and full benefits. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members. Additional responsibilities to include but not limited to the following: - 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. - Develops a 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. - Services strategies policies and programs are comprised of network management and clinical coverage policies. - Our Care Managers are frontline advocates for members who cannot reputed company for themselves. -They are responsible for 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. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to reputed company programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company health and social indicators which reputed company planning and resolution of member issues. - Assessments take into account information from various sources to address reputed company conditions including co-morbid and multiple diagnoses that 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 g 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. - 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 conversation. Required Qualifications - Must have active and unrestricted Registered Nurse (RN) licensure in the state of Ohio or a Compact license - 2 years of RN experience - Must be willing and able to travel 50-75% of the time in reputed company, Clermont, or reputed company County. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy Preferred Qualifications - Home Health experience - Computer Skills (reputed company office such as: Word, reputed company, and outlook) - Bachelor of Science in Nursing Education Associate's Degree in Nursing Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 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, visithttps://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 04/25/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. reputed company 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 reputed company of your vaccination status or apply for a reasonable accommodation reputed company the first 10 days of your employment. Please note that in some states and roles, you may be required to provide reputed company of full vaccination or an approved reasonable accommodation before you can reputed company to actively work. reputed company 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 reputed company essential job functions. reputed company 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 reputed company Services (TRS). We will reputed company every effort to respond to your request reputed company 48 business hours and do everything we can to work towards a solution. Apply Job!