A1A Case Manager RN - Registered Nurse - AZ

About This Role

The A1A Case Manager RN role at CVS Health involves telephonic and face-to-face assessments, planning, implementing, and coordinating case management activities to enhance member wellness. This position is ideal for experienced RNs looking to make a significant impact in healthcare delivery.

Highlights

• Pay : $60,522 - $129,615/year
• Location : Remote, AZ
• Brand/Division : Aetna One Advocacy (A1A)
• Schedule : Full-time, 8am-4:30pm AZ Time
• Residency : Must reside within a commutable distance of Phoenix, AZ (typically within 45 minutes maximum)

What You'll Do

• Develop proactive courses of action to enhance member outcomes and overall wellness.
• Conduct evaluations of member needs and benefit plan eligibility using clinical tools.
• Apply clinical judgment to reduce risk factors and address complex health indicators.
• Assess members' conditions, including co-morbidities and multiple diagnoses.
• Review prior claims to evaluate their impact on current case management.
• Assess members' work capacity and related restrictions/limitations.
• Use a holistic approach to determine the need for referrals to clinical resources.
• Consult with supervisors to overcome barriers in meeting goals and objectives.
• Present cases at conferences for multidisciplinary focus on claim management.
• Utilize case management processes in compliance with regulatory and company policies.

Requirements

Education :

• Associates Degree in Nursing required, BSN preferred.

Experience :

• 3+ years of clinical practice experience as an RN required.

Licenses & Certifications :

• Current RN License in state of residence required, preferably with multi-state/compact privileges.
• Must be willing to obtain all 50 state licenses upon hire.

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources

About CVS Health

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on innovation and accountability, striving to simplify healthcare for individuals and communities.