Case Manager, Registered Nurse

CVS Health Careers

. Coordinate and facilitate comprehensive care for individuals by assessing needs, developing personalized care plans, and coordinating services across healthcare providers .

Posted 10/30/2026full-timeRemote • Michigan • United StatesJuniorMid-Level💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management and patient advocacy, with a strong focus on developing personalized care plans and coordinating services across healthcare providers. Proficient in utilizing clinical tools for assessing patient needs and ensuring compliance with healthcare regulations.

Highest-signal resume keywords

Active RN Licensure In Michigan3+ Years Clinical Practical Experience2+ Years Case Management ExperienceNational Professional Certification PreferredProficiency With Microsoft Office Suite

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Case Management ProcessesMedical TerminologyClinical AssessmentCare Plan DevelopmentBenefit Eligibility EvaluationDigital Literacy SkillsTime ManagementProblem-Solving SkillsDecision-Making SkillsTechnical Troubleshooting

Soft Skills

Effective CommunicationTactful Customer InteractionEthical Handling Of Sensitive InformationAdaptability In Fast-Paced EnvironmentsOpenness To Learning New Skills

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft Office 365Google WorkspaceVPN/EHR PortalsSecure Systems AccessTeams MessagingVirtual Meeting Platforms

Certifications & Qualifications

Active RN LicensureCompact Registered Nurse LicensureCRCCDMSCRRNCOHNCCM

Industry Keywords

Healthcare CoordinationPatient AdvocacyChronic Illness ManagementHome Health CareMedicare MembersRegulatory ComplianceRehabilitation-Service LawsDischarge PlanningPalliative CareCatastrophic Case Management

About the role

Key responsibilities & impact

Coordinate and facilitate comprehensive care for individuals by assessing needs, developing personalized care plans, and coordinating services across healthcare providers
Advocate for patients and ensure effective communication, resource utilization, and continuous progress monitoring
Act as liaison among members/clients/families, employers, providers, insurance companies, and healthcare personnel
Coordinate case management activities for catastrophic cases and chronically ill members/clients across the continuum of care
Coordinate consultant referrals, home care visits, community resources, and alternative levels of care
Interact with members/clients telephonically or in person, including at homes, worksites, or physician offices
Assess and analyze medical and/or vocational status
Develop plans of care to optimize wellness and medical outcomes, support timely return to work, and determine benefit eligibility
Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers
Prepare required case work documentation
Consult with internal multidisciplinary teams
Contact treating physicians or specialists regarding course of care and treatment
Provide education and prevention information
Apply applicable rehabilitation-service laws, regulations, insurer instructions, and referral-source requirements
Evaluate member/client needs and benefit plan eligibility using clinical tools and data
Apply case management processes in compliance with regulatory and company policies
Develop proactive actions to improve short- and long-term outcomes and overall wellness
Monitor progress toward desired outcomes through assessment and evaluation

Requirements

What you’ll need

Preferably resides in Michigan
Active and unrestricted RN licensure in Michigan
Active and unrestricted Compact Registered Nurse (RN) Licensure in state of residence (MI)
3+ years of clinical practical experience preferred in areas including diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, or home health with Medicare members
2+ years of case management, discharge planning and/or home health care coordination experience
Proficiency with Microsoft Word, Excel, Outlook, PowerPoint, and proprietary applications
Ability to work in a fast-paced, high-volume environment using time management and prioritization skills
Efficient computer skills, including navigating multiple systems and keyboarding
Working knowledge of problem-solving and decision-making skills
Working knowledge of medical terminology
Working knowledge of digital literacy skills
Ability to deal tactfully with customers and community
Ability to handle sensitive information ethically and responsibly
Ability to evaluate relative costs and benefits of potential actions
National professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred
Bachelor's Degree in Nursing preferred
Associate's Degree in Nursing required
Direct/hardwired internet connection within 7 feet of modem/router, with minimum 25 Mbps download and 3 Mbps upload
Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where currently living
Ability to provide own workspace furniture
Ability to navigate multiple monitors and applications
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar Google Workspace
Ability to access secure systems, use VPN/EHR portals, secure devices, manage strong passwords, and identify suspicious emails or links
Ability to troubleshoot common technical issues
Openness to learning new skills

Benefits

Comp & perks

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 (keyboard, monitor, computer, headset, etc.)
CVS Health bonus, commission or short-term incentive program eligibility