[Hiring] Pediatric Case Manager Registered Nurse @CVS Health

Role Description

Coordinates all case management activities with pediatric members to evaluate medical needs and to facilitate the overall wellness of pediatric members. Develops strategy to address issues to outcomes and opportunities to enhance members overall wellness through integration.

• Instructs programs and procedures in compliance with network management and clinical coverage policies.

Qualifications

• Must reside in Louisiana in one of the following parishes: Region-1: Orleans, Jefferson, St. Bernard and Plaquemines parishes.
• Current/Active Clinical Licensure (RN)
• Case Management experience
• Strong customer service orientation and problem solving
• Excellent Communication/Telephonic skills
• Excellent motivational interviewing skills/ability to build rapport and trust telephonically
• Excellence in documentation and respecting compliance/regulatory standards
• Highly organized, remain self-driven without direct supervision
• Manage time effectively
• Achieve performance metrics
• Technology proficiency
• Ability to travel within 125 miles round trip for 1 day in the field
• Variable work schedule with ability to work 2 days weekly until 9pm local time
• Pediatric experience

Requirements

• Bachelors and/or Master's Degree
• CCM Certification
• Previous experience in Managed Care Organization

Benefits

• Comprehensive and competitive mix of pay and benefits
• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility