Case Manager, Registered Nurse

CVS Health

. Telephonically and/or face to face assess, plan, implement, and coordinate case management activities with members .

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

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, clinical assessment, and member engagement while ensuring compliance with regulatory standards. Proficient in utilizing technology for effective communication and data management in a virtual work environment.

Highest-signal resume keywords

Active RN License3+ Years Acute Care Clinical ExperienceCase ManagementMicrosoft Office 365HIPAA Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentCase Management ProcessesInterviewing SkillsData EvaluationRisk Factor ReductionTechnical TroubleshootingEHR Portal NavigationDischarge PlanningPediatrics ExperienceICU Experience

Soft Skills

Communication SkillsCollaborationAdaptabilityEngagementOpenness to Learning

Tools & Technologies

Microsoft Office 365Google WorkspaceVPNEHR SystemsMultiple Monitors

Certifications & Qualifications

Active RN LicenseAssociate Degree in Nursing

Industry Keywords

Case ManagementAcute CareHIPAA GuidelinesNurse Licensure CompactHealth Outcomes

About the role

Key responsibilities & impact

Telephonically and/or face to face assess, plan, implement, and coordinate case management activities with members
Evaluate members’ medical needs to facilitate overall wellness
Collaboratively develop proactive courses of action to improve short- and long-term outcomes
Review clinical tools and information/data, including assessments and claims
Evaluate member needs and available benefits and refer members to plan sponsor programs
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 between 8:30 a.m. and 5:00 p.m. in the employee’s time zone for a scheduled 8-hour shift
Potentially work weekends and holidays on an on-call, volunteer basis
Travel less than 5% for on-site meetings, trainings, system updates, or licensure requirements

Requirements

What you’ll need

Must have an active current and unrestricted RN license in state of residence
Candidates in a Nurse Licensure Compact jurisdiction must be able to use their compact license without restriction
Willingness and ability to obtain additional state licenses upon hire
3+ years of acute care clinical experience as an RN, including general medical, post-surgical, specialty, pediatrics, ICU, case management or discharge planning
Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods
Private designated workspace free of distractions and 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 and private designated home virtual work location compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where currently residing
Ability to obtain required internet speeds and adhere to Work From Home requirements
Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace applications
Ability to log in to secure systems such as VPN and EHR portals, lock computer screens, manage strong passwords, and recognize suspicious emails or links
Ability to troubleshoot 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 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, headset, etc.
Additional state licenses paid for by the company