Case Manager, Registered Nurse

CVS Health

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

Posted 11/4/2026full-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 and care coordination for chronic and catastrophic health conditions, utilizing strong analytical and communication skills to optimize patient outcomes. Proficient in navigating healthcare systems and regulations while providing education and advocacy for members and families.

Highest-signal resume keywords

Active Registered Nurse LicensureCase Management ExperienceClinical Practical ExperienceNational Professional CertificationBilingual Spanish

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementCare CoordinationClinical AssessmentPlan DevelopmentDocumentation PreparationPatient EducationRegulatory ComplianceData EvaluationHome Health Care CoordinationDischarge Planning

Soft Skills

Analytical SkillsProblem-Solving SkillsEffective CommunicationOrganizational SkillsInterpersonal Skills

Tools & Technologies

Microsoft Office 365Google WorkspaceVPN AccessEHR PortalsTeams Messaging

Certifications & Qualifications

CRCCDMSCRRNCOHNCCM

Industry Keywords

Chronic Illness ManagementMedicarePalliative CareHome CareRehabilitation Services

About the role

Key responsibilities & impact

Perform collaborative assessment, planning, facilitation, care coordination, evaluation, and advocacy for members’ and families’ comprehensive health needs
Act as liaison among members/clients/families, employers, providers, insurance companies, and healthcare personnel
Coordinate case management activities for catastrophic cases and chronically ill members/clients across the continuum of care
Conduct consultant referrals, home care visits, use of community resources, and alternative levels of care as needed
Interact with members/clients telephonically or in person, including at homes, worksites, or physician offices
Assess and analyze medical and/or vocational status of injured, acute, or chronically ill members/clients
Develop plans of care to optimize wellness, medical outcomes, return to work, and functioning
Communicate with members/clients and stakeholders including medical providers, attorneys, employers, and insurance carriers
Prepare required documentation of case work activities
Consult with internal multidisciplinary teams
Contact treating physicians or specialists regarding course of care and treatment
Provide education and prevention information
Apply rehabilitation-services laws, regulations, insurance-carrier instructions, and referral-source requirements
Testify as required to substantiate case work or reports
Evaluate member needs and benefit-plan eligibility using clinical tools and data
Monitor 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

Candidate must reside in the South Region: OH, VA, NC, KY, TN, SC, GA, AL, MS, AR, LA, FL
Must be willing to work Monday–Friday, 8:00am–5:00pm EST
Active and unrestricted Compact Registered Nurse (RN) Licensure in OH or in the candidate’s state of residence
3+ years clinical practical experience, preferably with diabetes, CHF, CKD, post-acute care, hospice, palliative care, or cardiac, with Medicare members
2+ years case management, discharge planning and/or home health care coordination experience
Associate's Degree or Nursing Diploma required
Bachelor's Degree preferred
Bilingual Spanish preferred
Excellent analytical and problem-solving skills
Effective communication, organizational, and interpersonal skills
Ability to work independently
Willingness and ability to obtain multi-state Registered Nurse licenses if needed
National professional certification such as 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 designated home virtual work location compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Must provide own workspace furniture
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 and recognize suspicious emails or links
Ability to resolve common technical issues independently

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
Company will provide required multi-state Registered Nurse licenses if needed