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Case Manager, Registered Nurse at CVS Health
, Texas, United States - Full Time
Skills Needed
Case Management, Clinical Judgment, Motivational Interviewing, Medical Necessity Review, Electronic Documentation, Care Planning, Patient Assessment, Utilization Review, Multidisciplinary Collaboration, Regulatory Compliance
Specialization
Requires a Registered Nurse license with 5+ years of experience, including at least one year in a hospital setting. Must have experience in specific clinical areas such as Oncology, Pediatrics, or Behavioral Health.
Experience Required
Minimum 5 year(s)
Health Professional Level 2 - Occupational Therapy at ACT Health
City of Edinburgh, Scotland, United Kingdom - Full Time
Skills Needed
Occupational Therapy, Clinical Reasoning, Patient Assessment, Problem Solving, Rehabilitation, Discharge Planning, Multidisciplinary Collaboration, Patient Care
Specialization
Candidates must be qualified Occupational Therapists with a commitment to collaborative, person-centered care. Required credentials include a National Police Check, Working with Vulnerable People registration, and compliance with vaccination and credentialing policies.
Experience Required
Minimum 2 year(s)
Oak Street Health New Graduate Nurse Practitioner Fellowship (Spanish Prefe at CVS Health
Rockford, Illinois, United States - Full Time
Skills Needed
Adult Primary Care, Patient Panel Management, Interprofessional Collaboration, Population Health, Clinical Excellence, Spanish Language, Older Adult Care, Value Based Care
Specialization
Candidates must be new graduate Nurse Practitioners (Family, Adult, or Adult-Gerontology) with a minimum 3.0 GPA and at least one year of recent RN experience. An active state NP license and passing board examinations are required by specified deadlines.
Warehouse Associate at giftHEALTH
Columbus, Ohio, United States - Full Time
Skills Needed
Inventory Management, Order Fulfillment, Warehouse Safety, Pallet Jack Operation, Forklift Operation, Basic Mathematics, Time Management, Attention To Detail, Logistics, Warehouse Management Systems, Shipping And Receiving, Physical Stamina
Specialization
Candidates must have a high school diploma and the physical ability to lift up to 50 lbs and stand for extended periods. Previous warehouse experience and familiarity with warehouse management systems are preferred.
Registered Nurse Level 2 - Clinical Development Nurse Ward 5A at ACT Health
City of Edinburgh, Scotland, United Kingdom - Full Time
Skills Needed
Clinical Leadership, Mentorship, Patient Centred Care, Clinical Education, Orthopaedic Nursing, Trauma Care, Wound Management, Musculoskeletal Care, Spinal Surgery Care
Specialization
Must be a Registered Nurse Level 2 with a passion for teaching and professional development. Successful candidates must undergo a National Police Check and comply with occupational health and vaccination policies.
Experience Required
Minimum 5 year(s)
Sustainability Manager at giftHEALTH
Columbus, Ohio, United States - Full Time
Skills Needed
Ecovadis Management, Sbti Target Setting, Ghg Accounting, Supply Chain Sustainability, Supplier Engagement, Esg Reporting, Data Analysis, Stakeholder Management, Program Design, Environmental Compliance, Sustainable Procurement, Cross Functional Leadership
Specialization
Requires a Bachelor's degree and 3 to 5 years of experience in supply chain or corporate sustainability. Must have hands-on experience with EcoVadis and SBTi, preferably within the healthcare or pharmaceutical industry.
Experience Required
Minimum 2 year(s)
Specimen Entry Officer - Pathology at ACT Health
victoria, Victoria, Australia - Full Time
Skills Needed
N/A
Physiotherapist at Healthstin
Australia, Manitoba, Australia - Full Time
Skills Needed
N/A
Store Associate at CVS Health
Seattle, Washington, United States - Full Time
Skills Needed
Customer Service, Cash Handling, Inventory Management, Retail Sales, Communication, Problem Solving, Merchandising, Point Of Sale (Pos)
Specialization
Candidates must be at least 16 years old and capable of performing physical tasks such as lifting up to 35 lbs and standing for long periods. Previous retail or customer service experience and a high school diploma are preferred.
Facilities Manager at PureHealth
Dubai, Dubai, United Arab Emirates - Full Time
Skills Needed
N/A
Physiotherapist at OTR Health
Australia, Manitoba, Australia - Full Time
Skills Needed
N/A
City Operations Manager at 2070Health
Bengaluru, karnataka, India - Full Time
Skills Needed
Operations Management, Stakeholder Coordination, Service Delivery, Inventory Management, Escalation Resolution, Process Improvement, Payment Reconciliation, Operational Metrics Tracking, Relationship Management, Logistics Coordination
Specialization
Candidates should have experience managing complex operations with multiple stakeholders, preferably in healthcare, diagnostics, logistics, or quick commerce. Strong organizational skills, clear communication, and a system-driven approach to task management are essential.
Experience Required
Minimum 2 year(s)
Remote Clinical Documentation Integrity Specialist (Bilingual in Spanish/En at Duo Health
San Juan, , Puerto Rico - Full Time
Skills Needed
Clinical Documentation Integrity, Icd 10 Cm Coding, Hcc Risk Adjustment, Bilingual Spanish English, Medical Record Review, Provider Education, Outpatient Risk Adjustment, Clinical Auditing, Medical Terminology, Pharmacology, Project Management, Analytical Thinking
Specialization
Requires at least 5 years of CDI experience, including 3 years in outpatient risk adjustment, and full fluency in Spanish and English. A bachelor's degree in nursing and professional certifications like CCS, CRC, or CDIP are preferred.
Experience Required
Minimum 5 year(s)
Safety, Health & Environment Manager at Aecom USA
Orange, California, United States - Full Time
Skills Needed
Incident Management, Safety Program Monitoring, Corrective Action Validation, Safety Training, Regulatory Compliance, Resource Assessment, Stakeholder Management, Data Analytics, Environmental Compliance, Team Leadership, Coaching, Risk Assessment
Specialization
Requires a Bachelor's degree in a relevant field, 10+ years of SH&E experience, and professional certification as a CSP or CIH. Candidates must have deep knowledge of OSHA, EPA, and DOT regulations, along with the ability to lead geographically dispersed teams.
Experience Required
Minimum 10 year(s)
Registered Nurse - Behavioral Health at Volunteers Of America, Utah
Salt Lake City, Utah, United States - Full Time
Skills Needed
Medication Management, Crisis Intervention, Nursing Assessment, Patient Education, Primary Care Coordination, Electronic Health Records, Clinical Documentation, Interdisciplinary Collaboration, Psychiatric Care, Substance Use Disorder Treatment, Microsoft Office, Patient Screening
Specialization
Must hold a current Utah RN license, be at least 21 years old with a valid driver's license, and possess CPR/First Aid certification. Experience in inpatient psychiatric settings and working with serious mental illness is preferred.
Experience Required
Minimum 2 year(s)
Occupational Safety & Health Officer at TOWNEPLACE SUITES BY MARRIOTT SAN DIEGO AIRPORT LIBERTY STATION
George Town, Penang, Malaysia - Full Time
Skills Needed
Cctv Monitoring, First Aid, Cpr, Incident Reporting, Hazard Inspection, Conflict Resolution, Emergency Response, Investigation, Evidence Gathering, Loss Prevention, Customer Service, Physical Security
Specialization
A high school diploma or GED is preferred, with no prior related work experience or supervisory experience required. Candidates must be physically capable of standing for long periods and lifting up to 50 pounds independently.
RN Director of Mental Health Program at Psychiatric Medical Care
Big Timber, Montana, United States - Full Time
Skills Needed
Clinical Leadership, Community Education, Referral Development, Patient Census Management, Compliance, Psychiatric Care, Geriatric Care, Team Management
Specialization
Must be a Registered Nurse graduated from a state-approved school of nursing. Psychiatric experience and a passion for working with older adults are preferred.
Experience Required
Minimum 5 year(s)
Behavioral Health Intake Supervisor at Ascension
Hoffman Estates, Illinois, United States - Full Time
Skills Needed
Performance Evaluation, Disciplinary Action Management, Admissions Services, Intake Services, Data Analysis, Results Reporting, Performance Improvement, Behavioral Health Supervision, Clinical Counseling, Social Work
Specialization
Requires a master's degree in social work, psychology, or a related field and previous lead or supervisory experience in behavioral health. A high school diploma with 2 years experience, an associate degree with 1 year, or 5 years of specific job experience is also listed as a minimum qualification.
Experience Required
Minimum 5 year(s)
Registered Nurse - Behavioral Health at Saint Barnabas Medical Center
New York, New York, United States - Full Time
Skills Needed
Behavioral Health Nursing, Substance Use Disorder Treatment, Patient Care, Interdisciplinary Collaboration, Bcls
Specialization
Candidates must hold a current NYS license to practice as a registered nurse and a current BCLS certification. Experience in Behavioral Health or Substance Use Disorders is preferred.
Experience Required
Minimum 2 year(s)
Medical Director in Community Health at Unity Care NW
Bellingham, Washington, United States - Full Time
Skills Needed
Clinical Leadership, Medical Program Management, Patient Care, Quality Improvement, Strategic Planning, Team Supervision, Operational Excellence, Data Driven Decision Making, Community Health Model, Epic Emr, Ambient Ai Scribe, Dragon Charting, Ambulatory Clinic Management, Mentoring, Healthcare Compliance, Cross Organizational Collaboration
Specialization
Requires an active Washington State Physician license, Board Certification in Family Medicine, and at least 5 years of experience as a physician. Must have experience in team-based care models and managing medical operations, preferably in an ambulatory or community health setting.
Experience Required
Minimum 5 year(s)
Case Manager, Registered Nurse at CVS Health
, Texas, United States -
Full Time


Start Date

Immediate

Expiry Date

28 Aug, 26

Salary

155538.0

Posted On

30 May, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Case Management, Clinical Judgment, Motivational Interviewing, Medical Necessity Review, Electronic Documentation, Care Planning, Patient Assessment, Utilization Review, Multidisciplinary Collaboration, Regulatory Compliance

Industry

Hospitals and Health Care

Description
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is a remote work from home role anywhere in the US with virtual training. American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members. Key Responsibilities 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. Required Qualifications 5+ years’ experience as a Registered Nurse with at least 1 year of experience in a hospital setting. The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support. 1+ years’ experience documenting electronically using a keyboard. 1+ years’ current or previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/ Obstetrics experience. 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. 1+ years' experience in Utilization Review. CCM and/or other URAC recognized accreditation preferred. 1+ years’ experience with MCG, NCCN and/or Lexicomp. Bilingual in Spanish preferred. Education Diploma or Associates Degree in Nursing required. BSN preferred. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $155,538.00 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. 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
Responsibilities
Perform telephonic case management for patients and care teams to ensure cost-effective quality care. Apply clinical guidelines and motivational interviewing to reduce risk factors and address complex health indicators.
Case Manager, Registered Nurse at CVS Health
, Texas, United States - Full Time
Skills Needed
Case Management, Clinical Judgment, Motivational Interviewing, Medical Necessity Review, Electronic Documentation, Care Planning, Patient Assessment, Utilization Review, Multidisciplinary Collaboration, Regulatory Compliance
Specialization
Requires a Registered Nurse license with 5+ years of experience, including at least one year in a hospital setting. Must have experience in specific clinical areas such as Oncology, Pediatrics, or Behavioral Health.
Experience Required
Minimum 5 year(s)
Health Professional Level 2 - Occupational Therapy at ACT Health
City of Edinburgh, Scotland, United Kingdom - Full Time
Skills Needed
Occupational Therapy, Clinical Reasoning, Patient Assessment, Problem Solving, Rehabilitation, Discharge Planning, Multidisciplinary Collaboration, Patient Care
Specialization
Candidates must be qualified Occupational Therapists with a commitment to collaborative, person-centered care. Required credentials include a National Police Check, Working with Vulnerable People registration, and compliance with vaccination and credentialing policies.
Experience Required
Minimum 2 year(s)
Oak Street Health New Graduate Nurse Practitioner Fellowship (Spanish Prefe at CVS Health
Rockford, Illinois, United States - Full Time
Skills Needed
Adult Primary Care, Patient Panel Management, Interprofessional Collaboration, Population Health, Clinical Excellence, Spanish Language, Older Adult Care, Value Based Care
Specialization
Candidates must be new graduate Nurse Practitioners (Family, Adult, or Adult-Gerontology) with a minimum 3.0 GPA and at least one year of recent RN experience. An active state NP license and passing board examinations are required by specified deadlines.
Warehouse Associate at giftHEALTH
Columbus, Ohio, United States - Full Time
Skills Needed
Inventory Management, Order Fulfillment, Warehouse Safety, Pallet Jack Operation, Forklift Operation, Basic Mathematics, Time Management, Attention To Detail, Logistics, Warehouse Management Systems, Shipping And Receiving, Physical Stamina
Specialization
Candidates must have a high school diploma and the physical ability to lift up to 50 lbs and stand for extended periods. Previous warehouse experience and familiarity with warehouse management systems are preferred.
Registered Nurse Level 2 - Clinical Development Nurse Ward 5A at ACT Health
City of Edinburgh, Scotland, United Kingdom - Full Time
Skills Needed
Clinical Leadership, Mentorship, Patient Centred Care, Clinical Education, Orthopaedic Nursing, Trauma Care, Wound Management, Musculoskeletal Care, Spinal Surgery Care
Specialization
Must be a Registered Nurse Level 2 with a passion for teaching and professional development. Successful candidates must undergo a National Police Check and comply with occupational health and vaccination policies.
Experience Required
Minimum 5 year(s)
Sustainability Manager at giftHEALTH
Columbus, Ohio, United States - Full Time
Skills Needed
Ecovadis Management, Sbti Target Setting, Ghg Accounting, Supply Chain Sustainability, Supplier Engagement, Esg Reporting, Data Analysis, Stakeholder Management, Program Design, Environmental Compliance, Sustainable Procurement, Cross Functional Leadership
Specialization
Requires a Bachelor's degree and 3 to 5 years of experience in supply chain or corporate sustainability. Must have hands-on experience with EcoVadis and SBTi, preferably within the healthcare or pharmaceutical industry.
Experience Required
Minimum 2 year(s)
Specimen Entry Officer - Pathology at ACT Health
victoria, Victoria, Australia - Full Time
Skills Needed
N/A
Physiotherapist at Healthstin
Australia, Manitoba, Australia - Full Time
Skills Needed
N/A
Store Associate at CVS Health
Seattle, Washington, United States - Full Time
Skills Needed
Customer Service, Cash Handling, Inventory Management, Retail Sales, Communication, Problem Solving, Merchandising, Point Of Sale (Pos)
Specialization
Candidates must be at least 16 years old and capable of performing physical tasks such as lifting up to 35 lbs and standing for long periods. Previous retail or customer service experience and a high school diploma are preferred.
Facilities Manager at PureHealth
Dubai, Dubai, United Arab Emirates - Full Time
Skills Needed
N/A
Physiotherapist at OTR Health
Australia, Manitoba, Australia - Full Time
Skills Needed
N/A
City Operations Manager at 2070Health
Bengaluru, karnataka, India - Full Time
Skills Needed
Operations Management, Stakeholder Coordination, Service Delivery, Inventory Management, Escalation Resolution, Process Improvement, Payment Reconciliation, Operational Metrics Tracking, Relationship Management, Logistics Coordination
Specialization
Candidates should have experience managing complex operations with multiple stakeholders, preferably in healthcare, diagnostics, logistics, or quick commerce. Strong organizational skills, clear communication, and a system-driven approach to task management are essential.
Experience Required
Minimum 2 year(s)
Remote Clinical Documentation Integrity Specialist (Bilingual in Spanish/En at Duo Health
San Juan, , Puerto Rico - Full Time
Skills Needed
Clinical Documentation Integrity, Icd 10 Cm Coding, Hcc Risk Adjustment, Bilingual Spanish English, Medical Record Review, Provider Education, Outpatient Risk Adjustment, Clinical Auditing, Medical Terminology, Pharmacology, Project Management, Analytical Thinking
Specialization
Requires at least 5 years of CDI experience, including 3 years in outpatient risk adjustment, and full fluency in Spanish and English. A bachelor's degree in nursing and professional certifications like CCS, CRC, or CDIP are preferred.
Experience Required
Minimum 5 year(s)
Safety, Health & Environment Manager at Aecom USA
Orange, California, United States - Full Time
Skills Needed
Incident Management, Safety Program Monitoring, Corrective Action Validation, Safety Training, Regulatory Compliance, Resource Assessment, Stakeholder Management, Data Analytics, Environmental Compliance, Team Leadership, Coaching, Risk Assessment
Specialization
Requires a Bachelor's degree in a relevant field, 10+ years of SH&E experience, and professional certification as a CSP or CIH. Candidates must have deep knowledge of OSHA, EPA, and DOT regulations, along with the ability to lead geographically dispersed teams.
Experience Required
Minimum 10 year(s)
Registered Nurse - Behavioral Health at Volunteers Of America, Utah
Salt Lake City, Utah, United States - Full Time
Skills Needed
Medication Management, Crisis Intervention, Nursing Assessment, Patient Education, Primary Care Coordination, Electronic Health Records, Clinical Documentation, Interdisciplinary Collaboration, Psychiatric Care, Substance Use Disorder Treatment, Microsoft Office, Patient Screening
Specialization
Must hold a current Utah RN license, be at least 21 years old with a valid driver's license, and possess CPR/First Aid certification. Experience in inpatient psychiatric settings and working with serious mental illness is preferred.
Experience Required
Minimum 2 year(s)
Occupational Safety & Health Officer at TOWNEPLACE SUITES BY MARRIOTT SAN DIEGO AIRPORT LIBERTY STATION
George Town, Penang, Malaysia - Full Time
Skills Needed
Cctv Monitoring, First Aid, Cpr, Incident Reporting, Hazard Inspection, Conflict Resolution, Emergency Response, Investigation, Evidence Gathering, Loss Prevention, Customer Service, Physical Security
Specialization
A high school diploma or GED is preferred, with no prior related work experience or supervisory experience required. Candidates must be physically capable of standing for long periods and lifting up to 50 pounds independently.
RN Director of Mental Health Program at Psychiatric Medical Care
Big Timber, Montana, United States - Full Time
Skills Needed
Clinical Leadership, Community Education, Referral Development, Patient Census Management, Compliance, Psychiatric Care, Geriatric Care, Team Management
Specialization
Must be a Registered Nurse graduated from a state-approved school of nursing. Psychiatric experience and a passion for working with older adults are preferred.
Experience Required
Minimum 5 year(s)
Behavioral Health Intake Supervisor at Ascension
Hoffman Estates, Illinois, United States - Full Time
Skills Needed
Performance Evaluation, Disciplinary Action Management, Admissions Services, Intake Services, Data Analysis, Results Reporting, Performance Improvement, Behavioral Health Supervision, Clinical Counseling, Social Work
Specialization
Requires a master's degree in social work, psychology, or a related field and previous lead or supervisory experience in behavioral health. A high school diploma with 2 years experience, an associate degree with 1 year, or 5 years of specific job experience is also listed as a minimum qualification.
Experience Required
Minimum 5 year(s)
Registered Nurse - Behavioral Health at Saint Barnabas Medical Center
New York, New York, United States - Full Time
Skills Needed
Behavioral Health Nursing, Substance Use Disorder Treatment, Patient Care, Interdisciplinary Collaboration, Bcls
Specialization
Candidates must hold a current NYS license to practice as a registered nurse and a current BCLS certification. Experience in Behavioral Health or Substance Use Disorders is preferred.
Experience Required
Minimum 2 year(s)
Medical Director in Community Health at Unity Care NW
Bellingham, Washington, United States - Full Time
Skills Needed
Clinical Leadership, Medical Program Management, Patient Care, Quality Improvement, Strategic Planning, Team Supervision, Operational Excellence, Data Driven Decision Making, Community Health Model, Epic Emr, Ambient Ai Scribe, Dragon Charting, Ambulatory Clinic Management, Mentoring, Healthcare Compliance, Cross Organizational Collaboration
Specialization
Requires an active Washington State Physician license, Board Certification in Family Medicine, and at least 5 years of experience as a physician. Must have experience in team-based care models and managing medical operations, preferably in an ambulatory or community health setting.
Experience Required
Minimum 5 year(s)
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