Case Manager, Registered Nurse

CVS Health

. Facilitate assessment, planning, care coordination, evaluation, and advocacy for members’ and families’ comprehensive health needs .

Posted 10/14/2026full-timeRemote • Illinois • United StatesJuniorMid-Level💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, care coordination, and health advocacy, with a strong focus on developing individualized care plans and facilitating communication among stakeholders. Proficient in utilizing clinical tools and data to evaluate member needs and ensure optimal health outcomes.

Highest-signal resume keywords

Active Illinois Registered Nurse LicenseCase Management ExperienceClinical Practical ExperienceCertified Case ManagerProficiency with Microsoft Office 365

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementCare CoordinationHealth AdvocacyClinical AssessmentIndividualized Care PlansCondition ManagementWellness FacilitationBenefit-Plan Eligibility EvaluationDocumentation PreparationMedical Outcomes Monitoring

Soft Skills

Analytical SkillsProblem-Solving SkillsEffective CommunicationOrganizational SkillsInterpersonal Skills

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft TeamsEHR PortalsVPN AccessDigital Communication Tools

Certifications & Qualifications

Registered Nurse LicenseCertified Case ManagerCRCCDMSCRRNCOHN

Industry Keywords

Home Health CarePalliative CareChronic Illness ManagementMedicareHIPAA Compliance

About the role

Key responsibilities & impact

Facilitate assessment, planning, care coordination, evaluation, and advocacy for members’ and families’ comprehensive health needs
Act as liaison among members/clients/families, employers, providers, insurance companies, attorneys, and healthcare personnel
Coordinate case management activities for catastrophic cases and chronically ill members across the continuum of care
Arrange consultant referrals, home care visits, community resources, and alternative levels of care
Interact with members/clients telephonically or in person, including at homes, worksites, or physicians’ offices when required
Assess and analyze medical and/or vocational status and develop individualized plans of care
Facilitate condition management, wellness, medical outcomes, eligibility determinations, and return to work or optimal functioning
Communicate with members and stakeholders regarding treatment and course of care
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 rehabilitation-services laws, regulations, and insurance-carrier instructions
Evaluate member needs and benefit-plan eligibility using clinical tools and data
Monitor member progress toward desired outcomes through assessment and evaluation
Develop proactive action plans to improve short- and long-term outcomes and overall wellness

Requirements

What you’ll need

Active and unrestricted Illinois (IL) Registered Nurse (RN) License
Associate's Degree or Nursing Diploma (REQUIRED)
2+ years case management, discharge planning and/or home health care coordination experience
3+ years clinical practical experience preferred, including diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac experience with Medicare members
Excellent analytical and problem-solving skills
Ability to occasionally travel within a designated geographic area for in-person case management activities
Effective communication, organizational, and interpersonal skills
Ability to work independently
Proficiency with Microsoft Word, Excel, Outlook, PowerPoint, Microsoft Office 365, Teams, and/or similar applications
Efficient computer skills, including navigating multiple systems and keyboarding
Willingness and ability to obtain multi-state Registered Nurse licenses if needed
Certified Case Manager preferred
National professional certification preferred: CRC, CDMS, CRRN, COHN, or CCM
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 work location
Ability to use multiple monitors and navigate multiple applications simultaneously
Ability to use digital communication tools such as email, calendar invites, Teams messaging, and virtual meetings
Ability to access secure systems such as VPN and EHR portals
Ability to manage strong passwords and recognize suspicious emails or links
Ability to troubleshoot common technical issues independently
Must work within the state and city where currently living

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.)
Company will provide required multi-state RN licenses if needed
Comprehensive benefits package for eligible full-time colleagues