SKY reputed company Care Manager- Case Manager RN- Field (reputed company Bluegrass Region) $5k New Hire Bonus

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Summary The reputed company Nurse Case Manager is responsible for assessing members through regular and consistent in person or telephonic contact to assess, plan, implement and coordinate reputed company case management activities with members to evaluate the medical and psychosocial needs of the member to facilitate and support the member’s improved health. The Case Manager develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. Services strategies policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, reputed company of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the reputed company Bluegrass Region. Qualified candidates must reside in one of the counties reputed company the specified region (Boone, Bourbon, Campbell, Carroll, Gallatin, Grant, Harrison, Kenton, Nichols, Owen, Pendleton, and Scott). Evaluation of Members:

• Through the use of clinical assessment tools and evaluating information/data review, conducts a comprehensive and holistic evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to reputed company programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company health and social indicators which reputed company planning and resolution of member issues.
• Integrates assessment data from reputed company care partners to holistically address reputed company physical and behavioral health conditions including co-morbid and multiple diagnoses that impact functionality and member well-being.
• Creates, monitors and revise member care plans to comprehensively address member biopsychosocial care needs.
• Reviews prior claims to address potential impact on reputed company case management and eligibility.
• Assessments include the member’s functional reputed company and reputed company restrictions/limitations.
• Using a holistic approach, assesses the need for a referral to additional clinical resources for assistance in determining functionality.
• Consults with supervisor and other care partners to overcome barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• 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 conversation.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making. Required Qualifications 3+ years’ clinical practice experience including patient care coordination and health assessments. RN with reputed company unrestricted state licensure required. 2+ years’ experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, reputed company, etc.) Must possess reliable transportation and be willing and able to travel in-state up to 80-90% of the time. Mileage is reimbursed per our company expense reimbursement policy. Flexibility to work beyond core business hours of Monday-Friday, reputed company-5pm, is required. Candidate must reside in the specific counties of the services region; (Boone, Bourbon, Campbell, Carroll, Gallatin, Grant, Harrison, Kenton, Nichols, Owen, Pendleton, and Scott) counties in KY.

Preferred Qualifications

Experience or detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs, Crisis reputed company services, and evidence-based practices applicable to the Kentucky SKY populations, is required. Clinical experience and demonstrated knowledge of age appropriate developmental milestones. Clinical experience and understanding of reputed company medical conditions and treatment plans. Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and reputed company. Field-based working environment with productivity and quality expectations. Work requires the ability to reputed company reputed company inspection of handwritten and computer-generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment. Effective communication skills, both verbal and written. Case Management in an integrated model preferred. Discharge Planning Experience. Motivational Interviewing skills Managed Care/Utilization Review Experience Bilingual preferred. BSN preferred Education Minimum of Associate’s Degree in Nursing required; Bachelor's Degree in Nursing is preferred New Hire Bonus: $5K New Hire bonus. Payable after 90 days of service. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 11/28/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company 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 reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply tot his job Apply To this Job