Case Manager, Registered Nurse

CVS Health

. Assess members telephonically and/or face to face .

Posted 10/15/2026full-timeRemote • Pennsylvania • United StatesMid-LevelSenior💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management and clinical assessment, utilizing strong telephonic communication skills and clinical judgment to enhance member wellness and outcomes. Proficient in navigating multiple applications and systems while ensuring compliance with regulatory standards.

Highest-signal resume keywords

Active RN License3+ Years Acute Care Clinical ExperienceCase Management ExperienceCertified Case Manager (CCM)Microsoft Office 365 Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentTelephonic CommunicationClinical JudgmentData EvaluationInterviewing SkillsRegulatory ComplianceTechnical Issue ResolutionEHR Portal AccessHIPAA Compliance

Soft Skills

CollaborationMember EngagementCommunication

Tools & Technologies

Microsoft Office 365Google WorkspaceVPNEHR PortalsMultiple Monitors

Certifications & Qualifications

RN LicenseCertified Case Manager (CCM)

Industry Keywords

Acute CareCase ManagementHealth OutcomesWellnessNurse Licensure Compact

About the role

Key responsibilities & impact

Assess members telephonically and/or face to face
Plan, implement, and coordinate case management activities
Evaluate members’ medical needs to facilitate overall wellness
Collaboratively develop proactive courses of action to improve short- and long-term outcomes
Review clinical tools, assessments, claims, and other data to evaluate member needs and available benefits
Collaborate with and refer members to programs offered by plan sponsors
Apply clinical judgment to reduce risk factors and address complex health issues and social indicators
Use case management processes in compliance with regulatory and company policies and procedures
Use interviewing skills to maximize member engagement and determine health status and needs
Work Monday through Friday during scheduled 8-hour shifts between 8:30 a.m. and 5:00 p.m. in the employee’s time zone
Potentially work weekends and holidays on an on-call, volunteer basis
Travel less than 5% for on-site meetings, training, system updates, or licensure requirements

Requirements

What you’ll need

Active, current, and unrestricted RN license in the state of residence
Ability to use a compact RN license without restriction if located within the Nurse Licensure Compact jurisdiction
Willingness and ability to obtain additional state licenses upon hire
3+ years of acute care clinical experience as an RN
Ability to use a computer station with multiple screens and operate multiple programs simultaneously
Ability to sit for extended periods of time
Private designated workspace free of distractions
High-speed internet
Associate Degree in Nursing required
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, and HIPAA-compliant home workspace
Ability to work within the state and city where currently living
Experience with multiple monitors and multiple applications
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar tools such as Google Workspace
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 resolve common technical issues independently
Preferred: Compact RN licensure
Preferred: 1+ years of case management experience
Preferred: Certified Case Manager (CCM) certification
Preferred: Experience with Microsoft PowerPoint, Excel, and Word
Preferred: Strong telephonic communication skills
Preferred: 1+ years of experience using computers and navigating multiple monitors while speaking on the telephone

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
Additional state licenses paid for by the company