Case Manager, Registered Nurse

CVS Health

. Use a collaborative process of assessment, planning, facilitation, and advocacy to meet members’ benefit plan and health needs .

Posted 10/23/2026full-timeRemote • New York • United StatesMid-LevelSenior💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, including conducting clinical assessments, developing care plans, and advocating for patients. Proficient in utilizing data-driven methods to enhance member engagement and promote quality healthcare outcomes.

Highest-signal resume keywords

Active RN License3+ Years Acute Care ExperienceCase Management PlanningClinical Decision-Making SkillsMicrosoft Office 365 Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentCare CoordinationData-Driven MethodsProblem-Solving SkillsMotivational InterviewingHealth Literacy AssessmentTechnical Issue ResolutionEHR NavigationVPN Access

Soft Skills

Excellent CommunicationRelationship-BuildingCustomer ServiceAdaptabilityTeam Collaboration

Tools & Technologies

Microsoft SuiteMicrosoft Office 365Google WorkspaceVPNEHR Portals

Certifications & Qualifications

Active RN LicenseAssociate Degree in Nursing

Industry Keywords

Healthcare CoveragePatient AdvocacyQuality ImprovementHIPAA ComplianceDiverse Patient Populations

About the role

Key responsibilities & impact

Use a collaborative process of assessment, planning, facilitation, and advocacy to meet members’ benefit plan and health needs
Assess members’ health status and care coordination needs
Conduct inpatient review and discharge planning
Develop, implement, monitor, and evaluate case management plans
Involve the Medical Director as indicated and close cases when discharge criteria are met
Apply data-driven methods to identify members for individualized case management programs or alternative healthcare referrals
Conduct comprehensive clinical assessments
Evaluate needs and develop flexible approaches based on member needs, benefit plans, or external programs/services
Advocate for patients within existing healthcare coverage
Promote quality, cost-effective outcomes and suggest improvements to program/operational efficiency
Identify and escalate quality-of-care issues through established channels
Provide a very high level of customer service
Assess health literacy, technology capabilities, and readiness to change
Use influencing and motivational interviewing skills to promote member engagement and lifestyle/behavior changes
Provide coaching, information, education, and support to empower independent medical and healthy lifestyle choices
Work in a queue-type setting
Work Monday–Friday between 8:00 a.m. and 5:00 p.m. in the residence time zone, with rotational evening, weekend, and holiday coverage as needed

Requirements

What you’ll need

Active and unrestricted RN license in state of residence
Ability to obtain multi-state licensure upon hire
3+ years of acute care experience as an RN
3+ years of experience with Microsoft Suite of products
Strong problem-solving and clinical decision-making skills
Ability to manage sensitive information with professionalism and confidentiality
Excellent communication and relationship-building skills
Ability to work effectively with diverse patient populations and healthcare teams
Minimum of 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 designated home work location compliant with CVS Health and HIPAA guidelines
Ability to work within the state and city where currently living
Ability to use multiple monitors and navigate multiple applications
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
Ability to follow computer security practices, manage strong passwords, and recognize suspicious emails or links
Ability to resolve common technical issues independently
Openness to learning new skills as the workplace environment evolves

Benefits

Comp & perks

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
CVS Health bonus, commission or short-term incentive program in addition to base pay range, subject to eligibility
No travel expected