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 10/5/2026full-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 and patient advocacy, with a strong focus on developing personalized care plans and coordinating services across healthcare providers. Proficient in utilizing clinical tools and data to assess needs and monitor progress while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Active Registered Nurse (RN) LicensureCase Management ExperienceClinical Practical ExperienceProficiency in Microsoft Office SuiteNational Professional Certification (CRC, CDMS, CRRN, COHN, or CCM)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementPatient AdvocacyCare Plan DevelopmentMedical TerminologyDigital Literacy SkillsAnalytical SkillsProblem SolvingDecision MakingTime ManagementPrioritization

Soft Skills

Effective CommunicationOrganizational SkillsInterpersonal SkillsTactful Customer InteractionEthical Handling of Sensitive Information

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft Office 365Google WorkspaceVPNEHR PortalsDigital Communication ToolsProprietary Applications

Certifications & Qualifications

Registered Nurse (RN)National Professional Certification (CRC)National Professional Certification (CDMS)National Professional Certification (CRRN)National Professional Certification (COHN)National Professional Certification (CCM)

Industry Keywords

Home Health CareChronic Illness ManagementPalliative CarePost-Acute CareMedicare MembersRegulatory ComplianceCare CoordinationCommunity ResourcesHealthcare ProvidersPatient Education

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 among 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 visits to homes, worksites, or physician offices
Assess medical and/or vocational status and develop plans of care to optimize wellness, medical outcomes, return to work, and functioning
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 applicable rehabilitation-service laws, regulations, and insurance-carrier instructions
Evaluate needs and benefit-plan eligibility using clinical tools and data
Comply with regulatory and company case-management policies and procedures
Develop proactive courses of action and monitor progress toward desired outcomes
Work remotely from a designated home workspace while supporting members in Florida or Ohio

Requirements

What you’ll need

Candidate must reside in either Florida or Ohio
Active and unrestricted Compact Registered Nurse (RN) Licensure in the state of residence (FL or OH)
3+ years of clinical practical experience preferred in areas 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
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)
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 workspace compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where currently residing
Must provide own workspace furniture
Ability to set up and use multiple monitors and navigate multiple applications
Ability to use digital communication tools including email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar applications such as Google Workspace
Ability to log into secure systems such as VPN and EHR portals, maintain 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 (keyboard, monitor, computer, headset, etc.)