Case Manager – Registered Nurse

CVS Health

. Assess, plan, implement, and coordinate case management activities telephonically and/or face to face .

Posted 10/6/2026full-timeRemote • United StatesJuniorMid-Level💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management activities, including assessment, planning, and implementation of care strategies to enhance member wellness. Proficient in utilizing clinical judgment and navigating digital communication tools while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Active RN Licensure2+ Years Clinical ExperienceCertified Case Manager (CCM)Microsoft Office 365 ProficiencyCase Management in Integrated Model

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentCare CoordinationDischarge PlanningHealth EvaluationRisk Factor ReductionCo-Morbidity AssessmentTechnical TroubleshootingEHR NavigationRegulatory Compliance

Soft Skills

CommunicationCollaborationProblem-SolvingInterpersonal SkillsAdaptability

Tools & Technologies

Microsoft Office 365VPN AccessEHR PortalsDigital Communication ChannelsMultiple Monitors

Certifications & Qualifications

Certified Case Manager (CCM)RN Licensure

Industry Keywords

Managed CareHIPAA ComplianceIntegrated Care ModelClinical ResourcesMember Engagement

About the role

Key responsibilities & impact

Assess, plan, implement, and coordinate case management activities telephonically and/or face to face
Evaluate members’ medical needs to facilitate overall wellness
Develop proactive courses of action to improve short- and long-term outcomes
Review clinical tools, information, data, prior claims, benefit eligibility, and member conditions
Facilitate transitions to Aetna programs and plans
Apply clinical judgment to reduce risk factors and address health and social barriers
Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations
Refer members to clinical resources when needed
Consult with supervisors and colleagues to overcome barriers
Present cases at multidisciplinary case conferences
Use case management processes in compliance with regulatory and company policies
Conduct interviews to engage members and determine health status and needs
Work Monday through Friday, 9:00 a.m.–5:30 p.m. in the time zone of residence, with occasional evening, weekend, and holiday shifts
No travel expected

Requirements

What you’ll need

Active RN licensure in the state where you reside
2+ years of clinical experience as an RN
Willingness and ability to obtain multiple state RN licensure after hire if chosen
Associate Degree in Nursing
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 you currently live
Ability to use multiple monitors and navigate multiple applications
Ability to use digital communication channels including email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications (Teams, Outlook, Word, Excel, PowerPoint) or similar Google Workspace tools
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
Preferred: Certified Case Manager (CCM) certification
Preferred: residence in a compact state
Preferred: 3+ years’ experience with Microsoft Office Suite
Preferred: case management in an integrated model
Preferred: discharge planning experience
Preferred: managed care experience
Preferred: BSN

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program
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 (keyboard, monitor, computer, headset, etc.)
Company-paid expenses for obtaining multiple state RN licensure after hire