Case Manager, Registered Nurse

CVS Health

. Develop proactive courses of action to address member issues and improve short- and long-term outcomes .

Posted 11/10/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical assessment and case management, utilizing clinical judgment to enhance member wellness and navigate complex health indicators. Proficient in using technology for remote work and maintaining compliance with regulatory standards.

Highest-signal resume keywords

Active Illinois RN Licensure2+ Years Clinical ExperienceCase Management ExperienceCertified Case Manager (CCM)Telephonic Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentCase Management ProcessesHolistic AssessmentsRisk Factor ReductionBenefit Plan Evaluation

Soft Skills

Problem SolvingInterpersonal CommunicationCollaboration

Tools & Technologies

Microsoft Office 365Google WorkspaceVPN AccessEHR Portals

Certifications & Qualifications

Certified Case Manager (CCM)Compact RN Licensure

Industry Keywords

HIPAA ComplianceIntegrated CareMember WellnessClinical ToolsTelehealth

About the role

Key responsibilities & impact

Develop proactive courses of action to address member issues and improve short- and long-term outcomes
Enhance members’ overall wellness through integrated care
Evaluate member needs and benefit plan eligibility using clinical tools and information/data review
Facilitate integrative functions and transitions to Aetna programs and plans
Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators
Conduct holistic assessments covering co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations
Review prior claims for potential impact on case management and eligibility
Assess need for referrals to clinical resources
Consult with supervisors and others to overcome barriers and meet goals and objectives
Present cases at multidisciplinary case conferences
Use case management processes in compliance with regulatory and company policies and procedures
Conduct interviews to engage members and determine health status and needs
Work remotely from home Monday through Friday, generally 9:00am–5:30pm in the resident’s time zone, with occasional late-shift rotation until 8:00pm EST
Flex an 8-hour shift between 8:00am and 6:00pm
No weekends, holiday shifts, or travel currently required

Requirements

What you’ll need

Active Illinois RN licensure required; candidate does not need to live in Illinois
2+ years of clinical experience as an RN
Associate’s degree in nursing minimum required
Ability to work 40 hours per week
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
WiFi and satellite internet are 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 workspace furniture, such as a desk or standing desk
Ability to use multiple monitors and navigate multiple applications
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications 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: 1+ years of case management experience
Preferred: Compact RN licensure or willingness and ability to obtain multiple state RN licensure after hire
Preferred: Certified Case Manager (CCM) certification
Preferred: Strong telephonic communication 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.)
Expenses paid by company for obtaining multiple state RN licensure after hire