Case Manager RN -KY

Job DescriptionThis position requires up to 10-50% travel in Southeastern, Western and Northern regions of KY. Prefers candidates located in those regions.Nurse Case Manager is responsible for 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 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.Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Required Qualifications- Minimum 5 years of clinical practice experience. All clinical experience will be considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, Telemetry, Medical / Surgical, Orthopedics, Long Term Care, and Infusion nursing health.-RN with current unrestricted state licensure in the state of Kentucky.- Minimum 2 years of Telephonic Case Management experience.- Minimum 2 years of Managed Care Experience.- Minimum 1+ years of MS office suite experience.-Willing and able to travel 10-50% of their time to meet members face to face in Southeastern, Western and Northern regions of KY. -Valid Drivers License required.COVID RequirementsCOVID-19 Vaccination RequirementCVS 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.Preferred Qualifications-Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. -Effective communication skills, both verbal and written.-Ability to multitask, prioritize and effectively adapt to a fast paced changing environment-Ability to utilize interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversationEducationMinimum Diploma in Nursing required. Associate or Bachelor's degree preferred.Business OverviewBring your heart to CVS HealthEvery 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.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-10-04