Case Manager, RN

CVS Health Careers

. Assess members’ health status and care coordination needs .

Posted 11/6/2026full-timeRemote • North Carolina • United StatesMid-LevelSenior💰 $54,095 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, including conducting clinical assessments, developing care plans, and advocating for patients. Proficient in utilizing data-driven methods to enhance healthcare outcomes and ensure compliance with regulatory standards.

Highest-signal resume keywords

Active RN LicenseCertified Case Manager (CCM)3+ Years Acute Care ExperienceTelephonic Case Management ExperienceManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentCare CoordinationDischarge PlanningData-Driven MethodsMotivational InterviewingPatient AdvocacyQuality ImprovementHealth Literacy AssessmentTechnology Capabilities Assessment

Soft Skills

Customer ServiceCollaborationInfluencing SkillsCoachingCommunication

Tools & Technologies

Microsoft Office 365Google WorkspaceVPNEHR PortalsMultiple Monitors

Certifications & Qualifications

Certified Case Manager (CCM)Compact RN License

Industry Keywords

Managed CareAcute CareHIPAA ComplianceHealthcare CoverageQuality of Care

About the role

Key responsibilities & impact

Assess members’ health status and care coordination needs
Conduct inpatient reviews and discharge planning
Develop, implement, monitor, and evaluate case management plans
Involve the Medical Director when indicated and close cases when discharge criteria are met
Use data-driven methods to identify members for individualized case management programs or alternative healthcare referrals
Conduct comprehensive clinical assessments
Evaluate member needs and develop flexible approaches based on benefit plans or external programs and services
Advocate for patients within existing healthcare coverage
Promote quality, cost-effective outcomes and suggest improvements to program and operational efficiency
Identify and escalate quality-of-care issues through established channels
Provide a very high level of customer service
Assess health literacy, technology capabilities, and readiness to change
Use influencing and motivational interviewing skills to engage members and promote lifestyle or behavior changes
Provide coaching, information, education, and support to empower independent medical and healthy lifestyle choices
Collaborate with members, healthcare resources, and Medical Directors through assessment, planning, facilitation, and advocacy

Requirements

What you’ll need

Active, current, and unrestricted RN license in state of residence
Willingness and ability to obtain additional state licenses upon hire
3+ years of acute care experience as an RN
Willingness to work Monday through Friday, 8:00am–4:30pm in the time zone of residence, with an occasional late shift rotation of 11:00am–8:00pm EST once per quarter
Associate Degree required
Compact RN License or multi-state licensure preferred
Certified Case Manager (CCM) preferred
Managed Care experience preferred
Hospital experience in ICU, CCU, Step Down, ER, or OR preferred
Telephonic case management and/or telephonic experience preferred
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 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 use multiple monitors and navigate multiple applications simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar Google Workspace applications
Ability to access secure systems such as VPN and EHR portals and follow security practices
Ability to troubleshoot common technical issues and contact IT when needed
Openness to learning new workplace skills

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 work equipment, including keyboard, monitor, computer, and headset
Company-paid additional state licenses upon hire