Case Manager, Registered Nurse

CVS Health

. Deliver comprehensive case management services through telephonic and/or face-to-face interactions .

Posted 11/11/2026full-timeRemote • United StatesMid-LevelSenior💰 $54,095 - $116,760 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management and acute care, utilizing clinical judgment to develop and implement care strategies that address members' medical needs and wellness. Proficient in using data-driven tools and collaborating with multidisciplinary teams to optimize care planning and ensure compliance with clinical guidelines.

Highest-signal resume keywords

Active RN License3+ Years Acute Care ExperienceCase Management ExpertiseHolistic Assessment SkillsMicrosoft Office 365 Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case Management ProcessesCare Plan DevelopmentClinical JudgmentHealth Risk EvaluationCo-Morbid Condition AssessmentReferral DeterminationData-Driven ToolsTelephonic InteractionFace-to-Face InteractionTechnical Troubleshooting

Soft Skills

Communication SkillsCollaborationProblem-SolvingAdaptabilityInterpersonal Skills

Tools & Technologies

EHR PortalsVPN AccessMultiple MonitorsEmail CommunicationTeams Messaging

Certifications & Qualifications

RN LicenseAssociate's Degree in Nursing

Industry Keywords

Acute CareMed/Surg ExperienceHIPAA ComplianceNetwork ManagementClinical Coverage Guidelines

About the role

Key responsibilities & impact

Deliver comprehensive case management services through telephonic and/or face-to-face interactions
Assess, plan, implement, and coordinate care strategies supporting members' medical needs and overall wellness
Apply case management processes and service strategies aligned with network management and clinical coverage guidelines
Interview and engage members to understand needs and facilitate transitions to appropriate programs and services
Use clinical judgment and data-driven tools to evaluate member eligibility and identify health risks
Develop proactive care plans addressing short- and long-term health outcomes
Conduct holistic assessments covering co-morbid conditions, functional limitations, and social determinants of health
Review prior claims and evaluate work capacity
Determine the need for referrals to clinical resources
Collaborate with supervisors and multidisciplinary teams to overcome barriers and optimize care planning

Requirements

What you’ll need

Active and unrestricted RN license in the state of residence
Willing and able to obtain additional state licenses upon hire
3+ years' experience of acute care and/or case management
2+ years' Med/Surg experience
Willingness to work Monday-Friday, 8:00am-4:30pm local time zone
Associate's Degree in Nursing
RN License in your state of residence
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
WiFi and satellite internet are not permitted
Quiet, secure, private designated home virtual work location 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 applications or similar Google Workspace applications
Ability to access secure systems such as VPN and EHR portals
Ability to follow computer security practices, including locking screens, managing strong passwords, and recognizing suspicious emails or links
Ability to troubleshoot common technical issues independently
Openness to learning new skills as the workplace evolves

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
Company-provided equipment (keyboard, monitor, computer, headset, etc.)
Required additional state licenses paid for by the company