Case Manager, Registered Nurse

CVS Health

. 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 • Illinois • United StatesJuniorMid-Level💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management and care coordination, with a strong focus on developing personalized care plans and advocating for patients. Proficient in utilizing clinical tools and data to assess needs and optimize wellness outcomes while ensuring compliance with healthcare regulations.

Highest-signal resume keywords

Active RN Licensure In IllinoisCase Management ExperienceClinical Practical Experience In Diabetes, CHF, CKDProficiency With Microsoft Office SuiteNational Professional Certification (CRC, CDMS, CRRN, COHN, CCM)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementCare CoordinationClinical AssessmentPersonalized Care PlansRegulatory ComplianceMedical TerminologyData EvaluationProblem SolvingDecision MakingDigital Literacy

Soft Skills

Effective CommunicationOrganizational SkillsInterpersonal SkillsTime ManagementTactfulness

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft Office 365Google WorkspaceVPN AccessEHR PortalsTeams MessagingVirtual Meeting Platforms

Certifications & Qualifications

Active RN LicensureNational Professional Certification (CRC, CDMS, CRRN, COHN, CCM)

Industry Keywords

Healthcare CoordinationPatient AdvocacyHome Health CareChronic Illness ManagementHIPAA ComplianceCommunity ResourcesSocial Determinants Of HealthInsurance CoordinationDischarge PlanningPalliative Care

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 monitoring of progress
Act as liaison with members/clients/families, employers, providers, insurance companies, and healthcare personnel
Implement and 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 possible home, worksite, or physician-office visits
Assess medical and/or vocational status and develop plans of care to optimize wellness, outcomes, functioning, and return to work
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 care and treatment
Provide education and prevention information
Apply laws, regulations, insurer instructions, and referral-source requirements
Evaluate member/client needs and benefit-plan eligibility using clinical tools and data
Follow case-management processes and regulatory and company policies
Develop proactive action plans and monitor progress toward desired outcomes
Coordinate with members, providers, and community organizations to address healthcare and social determinant needs

Requirements

What you’ll need

Candidate preferably resides in Illinois
Active and unrestricted RN licensure in Illinois
Associate's Degree in Nursing (REQUIRED)
2+ years of case management, discharge planning and/or home health care coordination experience
3+ years of clinical practical experience preferred in diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, or Home Health with Medicare members
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
Working knowledge of problem solving, decision making, medical terminology, and digital literacy
Ability to deal tactfully with customers and community
Ability to handle sensitive information ethically and responsibly
National professional certification preferred: CRC, CDMS, CRRN, COHN, or CCM
Excellent analytical and problem-solving skills preferred
Effective communication, organizational, and interpersonal skills preferred
Bilingual Spanish preferred
Active and unrestricted Compact Registered Nurse (RN) licensure in state of residence (Illinois)
Direct/hardwired internet connection to modem/router within 7 feet and minimum speeds of 25 Mbps download and 3 Mbps upload; WiFi and satellite internet not permitted
Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Must provide own workspace furniture
Ability to use multiple monitors and applications simultaneously
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, follow security practices, and recognize suspicious emails or links
Ability to troubleshoot common technical issues and contact IT when needed
Openness to learning new 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 equipment including keyboard, monitor, computer, and headset