Case Manager, Registered Nurse

CVS Health

. Assess, coordinate, and manage care for members with complex medical needs .

Posted 10/16/2026full-timeRemote • Texas • United StatesMid-LevelSenior💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Care Management and Utilization Management, with a focus on developing personalized care plans and improving health outcomes for members with complex medical needs. Proficient in clinical judgment, collaboration with multidisciplinary teams, and effective telephonic engagement.

Highest-signal resume keywords

Active RN License5+ Years RN Clinical Practice ExperienceCase Management CertificationCritical Care ExperienceUtilization Management Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementUtilization ManagementClinical JudgmentTelephonic Care ManagementHealth CoachingCase ManagementTransplant Nursing ExperienceMicrosoft Office 365EHR Portals AccessTechnical Troubleshooting

Soft Skills

CollaborationCommunicationProblem-SolvingAdaptabilityInterpersonal Skills

Tools & Technologies

VPNEmailCalendar InvitesTeams MessagingVirtual MeetingsMultiple MonitorsSecure Systems

Certifications & Qualifications

Case Management CertificationRN LicenseAssociate Degree in Nursing

Industry Keywords

Complex Medical NeedsHealth OutcomesBarriers to CareInterdisciplinary TeamsHIPAA Compliance

About the role

Key responsibilities & impact

Assess, coordinate, and manage care for members with complex medical needs
Develop proactive care plans to improve short- and long-term health outcomes
Identify clinical, social, and functional barriers impacting care
Collaborate with healthcare providers and multidisciplinary teams
Apply clinical judgment to utilization and care management decisions
Engage members through telephonic care management and health coaching
Support members with complex healthcare needs through Case Management and Utilization Management
Partner with members, providers, and interdisciplinary teams to develop personalized care plans, improve outcomes, reduce barriers to care, and promote wellness

Requirements

What you’ll need

Active, unrestricted Compact RN license in state of residence
5+ years of RN clinical practice experience
2+ years of critical care experience
6+ months of Case Management or Utilization Management experience
Ability to work Monday-Friday, 8:00 AM-5:00 PM in local time zone
Willingness to obtain additional state RN licenses
Associate Degree in Nursing required
Case Management Certification (CCM or equivalent) preferred
Transplant nursing experience preferred
BSN preferred
Direct/hardwired internet connection to a modem/router within 7 feet of 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 residing
Comfortable setting up and using multiple monitors and navigating multiple applications
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace applications
Ability to access secure systems such as VPN and EHR portals
Ability to follow computer security practices, manage strong passwords, and recognize suspicious emails or links
Ability to troubleshoot common technical issues independently
Openness to learning new skills as the workplace evolves

Benefits

Comp & perks

Company-sponsored multi-state licensure
100% remote work environment
No nights, weekends, or holidays currently required
Company-provided equipment (keyboard, monitor, computer, headset, etc.)
Medical, dental, and 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 in addition to base pay