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 • Massachusetts • 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 for chronic and catastrophic health conditions, utilizing strong clinical assessment skills and effective communication with multidisciplinary teams and stakeholders. Proficient in developing personalized care plans and monitoring patient progress while adhering to regulatory and ethical standards.

Highest-signal resume keywords

Active RN Licensure in MACase Management ExperienceClinical Practical ExperienceMicrosoft Office ProficiencyNational Professional Certification (CRC, CDMS, CRRN, COHN, or CCM)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentCare Plan DevelopmentPatient AdvocacyMedical TerminologyProblem SolvingDecision MakingDigital LiteracyTime ManagementData EvaluationTechnical Issue Resolution

Soft Skills

Effective CommunicationOrganizational SkillsInterpersonal SkillsTactful Customer InteractionEthical Handling of Sensitive Information

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft Office 365Google WorkspaceEHR PortalsVPN AccessSecure Systems NavigationMultiple Monitor Usage

Certifications & Qualifications

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

Industry Keywords

Case ManagementHome Health CareChronic IllnessPalliative CareMedicareDischarge PlanningPatient EducationResource UtilizationHealthcare CoordinationHIPAA Compliance

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 progress monitoring
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 potentially in homes, worksites, or physician offices
Assess injured, acute, or chronically ill members’/clients’ medical and vocational status
Develop plans of care to optimize wellness, medical outcomes, return to work, and functional outcomes
Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers
Prepare required documentation of case work activities
Consult with internal multidisciplinary teams
Contact treating physicians or specialists regarding courses of care and treatment
Provide education and prevention information
Apply laws, regulations, insurance-carrier 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

Candidate preferably resides in MA
Active and unrestricted RN licensure in MA
3+ years of clinical practical experience preferred, including 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
Working knowledge of problem solving and decision-making skills
Working knowledge of medical terminology
Working knowledge of digital literacy skills
Ability to deal tactfully with customers and community
Ability to handle sensitive information ethically and responsibly
Ability to evaluate relative costs and benefits of potential actions
National professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred
Excellent analytical and problem-solving skills preferred
Effective communication, organizational, and interpersonal skills preferred
Bilingual Spanish preferred
Associate's Degree in Nursing required
Bachelor's Degree in Nursing preferred
Active and unrestricted Compact Registered Nurse (RN) Licensure in the state of residence (MA)
Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum 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
Must work within the state and city where currently living
Must provide own workspace furniture
Must be able to use multiple monitors and applications simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar Google Workspace applications
Ability to log in to secure systems such as VPN and EHR portals, secure devices, manage strong passwords, and recognize suspicious emails or links
Ability to resolve 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 the base pay range
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.)