A1A Case Manager RN - Registered Nurse - OH

About This Role

The RN Case Manager role at CVS Health is part of Aetna One Advocacy (A1A) and involves assessing, planning, implementing, and coordinating case management activities to enhance member wellness. This position is ideal for experienced nurses who are passionate about providing high-quality care and support to members.

• Pay: $60,522 - $129,615/year
• Location: Remote, OH
• Residency: Must live within a commutable distance of New Albany, Ohio (typically within 45 minutes maximum)
• Schedule: Full-time, 8am-4:30pm EST with occasional later shifts

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

• Associates Degree in Nursing required
• BSN preferred

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

• Unrestricted RN license in state of residence required, preferably with multi-state/compact privileges
• Willingness to obtain all 50 state licenses upon hire

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

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.