Required Qualifications

• Active and unrestricted Registered Nurse (RN) license in the applicable state.
• Minimum of 3 to 5 years of clinical nursing experience, preferably in care management, case management, home care, long-term care, managed care, utilization management, or community-based healthcare settings.
• Experience coordinating care for members with complex medical, behavioral health, and psychosocial needs.
• Strong knowledge of chronic disease management, care coordination, and healthcare delivery systems.
• Ability to perform clinical assessments, identify member needs, and develop comprehensive care plans.
• Excellent communication, organizational, critical thinking, and problem-solving skills.
• Proficiency in Microsoft Office applications and electronic documentation systems.
• Ability to work independently while effectively collaborating with interdisciplinary teams.

Preferred Qualifications

• Certified Case Manager (CCM) certification or willingness to obtain certification.
• Experience working in Managed Long-Term Care (MLTC), Medicare, Medicaid, Dual Eligible, or other managed care populations.
• Knowledge and experience with the Uniform Assessment System (UAS-NY) and person-centered service planning.
• Experience coordinating home and community-based services (HCBS), long-term services and supports (LTSS), and behavioral health services.
• Bilingual skills preferred.
• Experience working in a remote or field-based care management environment

Education

• Bachelor's Degree in Nursing (BSN) preferred.
• Current, unrestricted Registered Nurse (RN) license required.
• Additional certifications in Case Management, Care Coordination, Utilization Management, or related specialties are preferred.

Work from Home Requirements

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and
• A minimum download speed of 25 mbs download and 3 mbs upload. Wi-Fi and satellite internet are not permitted.
• A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS
• Health and HIPAA guidelines and allowing for uninterrupted work during work hours.
• Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
• The company will provide equipment (keyboard, monitor, computer, headset, etc.).
• All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
• If hired, you will commit to obtaining required internet speeds and adhere to all Work from Home requirements.

Technical and Logistical Requirements

• Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
• Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
• Collaboration & Scheduling:
• Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
• Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
• Troubleshooting & Support: Ability to resolve common technical issues independently, such as restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
• Future Growth: Openness to learning new skills in the future as the workplace environment evolves

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range

The typical pay range for this role is

$66,575.00 - $142,576.00