Case Manager, Registered Nurse

CVS Health

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

Posted 10/6/2026full-timeRemote • United StatesJuniorMid-Level💰 $54,095 - $116,760 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management and care coordination for chronic and catastrophic health conditions, utilizing clinical assessment and evaluation to optimize patient outcomes. Proficient in navigating healthcare systems and collaborating with multidisciplinary teams to advocate for members' health needs.

Highest-signal resume keywords

Active Registered Nurse LicensureCase Management ExperienceClinical Practical ExperienceMicrosoft Office ProficiencyBilingual Spanish Ability

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentCare Plan DevelopmentBenefit Plan Eligibility EvaluationRehabilitation-Service RegulationsHome Health CoordinationDischarge PlanningMedical DocumentationData EvaluationTechnical Issue ResolutionTime Management

Soft Skills

CommunicationAdvocacyInterpersonal SkillsOrganizational SkillsOpenness to Learning

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft Office 365Google WorkspaceEHR PortalsVPN AccessTeams MessagingVirtual Meeting Platforms

Certifications & Qualifications

Registered Nurse LicensureCertified Case ManagerNational Professional Certification (CRC, CDMS, CRRN, COHN, or CCM)

Industry Keywords

Chronic Health ConditionsCatastrophic CasesHome HealthPalliative CareMedicare MembersHealthcare PersonnelCommunity ResourcesWellness OptimizationInsurance CoordinationHIPAA Compliance

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

Active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida
3+ years of clinical practical experience preferred in 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 and use time management and prioritization skills
Efficient computer skills, including navigating multiple systems and keyboarding
Associate's Degree in Nursing or Nursing Diploma required
Bachelor's Degree in Nursing preferred
Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload; WiFi and satellite internet are not permitted
Quiet, secure, private, distraction-free home workspace compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Ability to obtain required internet speeds and comply with Work From Home requirements
Ability to set up and use multiple monitors and navigate multiple applications
Ability to use 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, maintain password security, and identify suspicious emails or links
Ability to resolve common technical issues independently
Openness to learning new skills
Spanish bilingual ability, Certified Case Manager credential, and national professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred

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
CVS Health bonus, commission or short-term incentive program eligibility
Company-provided equipment including keyboard, monitor, computer, and headset