Case Manager, Registered Nurse

CVS Health Careers

. Assess, plan, facilitate, coordinate, evaluate, and advocate for services addressing members’ and families’ comprehensive health needs .

Posted 11/4/2026full-timeRemote • United StatesMid-LevelSenior💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in case management and coordination of care for Medicare members, with a focus on optimizing wellness and medical outcomes. Proficient in utilizing clinical tools, navigating EHR systems, and adhering to HIPAA guidelines while providing education and support to clients and families.

Highest-signal resume keywords

Active Registered Nurse (RN) Licensure3+ Years Clinical Practical Experience2+ Years Case Management ExperienceExperience with Microsoft Office 365Bilingual Spanish Preferred

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementDischarge PlanningClinical AssessmentCare CoordinationMedical Outcome OptimizationData EvaluationTechnical Issue ResolutionEHR NavigationRegulatory CompliancePlan of Care Development

Soft Skills

Effective CommunicationOrganizational SkillsInterpersonal SkillsAnalytical SkillsProblem-Solving Skills

Tools & Technologies

Microsoft Office 365VPNEHR PortalsTeamsGoogle Workspace

Certifications & Qualifications

Compact Registered Nurse (RN) LicensureNational Professional Certification (CRC, CDMS, CRRN, COHN, CCM)

Industry Keywords

MedicareChronic Illness ManagementHome Health CarePalliative CareRehabilitation Services

About the role

Key responsibilities & impact

Assess, plan, facilitate, coordinate, evaluate, and advocate for services addressing members’ and families’ comprehensive health needs
Act as liaison among members/clients, families, employers, providers, insurers, attorneys, and healthcare personnel
Coordinate case management activities for catastrophic cases and chronically ill Medicare members across the continuum of care
Arrange consultant referrals, home care visits, community resources, and alternative levels of care
Interact with members/clients telephonically or in person, including possible visits to homes, worksites, or physician offices
Assess medical and vocational status and develop plans of care to optimize wellness, medical outcomes, functioning, and return to work
Communicate with members/clients and stakeholders regarding care and treatment
Prepare required case work documentation and reports
Consult with internal multidisciplinary teams
Contact treating physicians and specialists regarding care and treatment
Provide education and prevention information
Apply laws, regulations, insurer instructions, and company policies governing rehabilitation and case management services
Testify as required to substantiate case work or reports
Evaluate needs and benefit-plan eligibility using clinical tools and data
Monitor member/client progress toward desired outcomes through assessment and evaluation
Develop proactive courses of action to improve short- and long-term outcomes and overall wellness

Requirements

What you’ll need

Candidate must reside in the South Region: OH, VA, NC, KY, TN, SC, GA, AL, MS, AR, LA, FL
Willingness to work Monday–Friday, 8:00am–5:00pm EST
Active and unrestricted Compact Registered Nurse (RN) Licensure in OH or in the candidate’s state of residence
3+ years clinical practical experience, preferably with diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac experience with Medicare members
2+ years case management, discharge planning and/or home health care coordination experience
Associate's Degree or Nursing Diploma required
Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications (Teams, Outlook, Word, Excel, PowerPoint) or similar Google Workspace applications
Ability to log in to secure systems such as VPN and EHR portals
Ability to maintain strong passwords, lock computer screens when unattended, and recognize suspicious emails or links
Ability to resolve common technical issues independently
Ability to obtain required internet speeds and comply with Work From Home requirements
Quiet, secure, private designated home work location compliant with CVS Health and HIPAA guidelines
Direct/hardwired internet connection within 7 feet of the computer with minimum 25 Mbps download and 3 Mbps upload speeds
Bachelor's Degree preferred
Bilingual Spanish preferred
National professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred
Excellent analytical and problem-solving skills preferred
Effective communication, organizational, and interpersonal skills preferred
Ability to work independently preferred
Openness to learning new skills preferred

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
Company-provided equipment including keyboard, monitor, computer, headset, etc.
Company-provided multi-state RN licenses if needed
Comprehensive benefits package for eligible full-time colleagues