Case Manager, Registered Nurse – NICU, Maternity, Women's Health

CVS Health

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

Posted 10/14/2026full-timeRemote • Arizona • United StatesMid-LevelSenior💰 $54,095 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management within NICU and maternity settings, utilizing clinical judgment to assess and coordinate care while ensuring compliance with regulatory standards. Proficient in telephonic case management and skilled in using clinical tools to evaluate member needs and improve health outcomes.

Highest-signal resume keywords

Active RN License3+ Years Clinical Experience in NICU1+ Year Case Management ExperienceCertified Case Manager (CCM)Telephonic Case Management Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentCare CoordinationCase Management ProcessesData ReviewRisk Factor ReductionCo-Morbidity AssessmentBenefit Plan EvaluationMicrosoft Office SuiteEHR Portal AccessTechnical Issue Resolution

Soft Skills

CommunicationMember EngagementCollaborationProblem-SolvingAdaptability

Tools & Technologies

Microsoft Office 365VPNEHR PortalsTelephonic Communication ToolsMultiple Monitor Setup

Certifications & Qualifications

Certified Case Manager (CCM)

Industry Keywords

NICUMaternity CareWomen's HealthIntegrated Case ManagementHIPAA Compliance

About the role

Key responsibilities & impact

Telephonically and/or face to face assess, plan, implement, and coordinate case management activities
Evaluate members' medical needs within a NICU/high-risk maternity case management program
Facilitate members' overall wellness and manage all aspects of their NICU and/or maternity journey
Develop proactive courses of action to address issues and improve short- and long-term outcomes
Evaluate member needs, benefit plan eligibility, and transitions to Aetna programs and plans using clinical tools and data review
Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators
Assess co-morbidities, multiple diagnoses, functionality, work capacity, and restrictions or limitations
Review prior claims for potential impact on case management and eligibility
Refer members to clinical resources when needed
Consult with supervisors and colleagues to overcome barriers and present cases at multidisciplinary case conferences
Use case management processes in compliance with regulatory and company policies
Conduct interviews to maximize member engagement and determine health status and needs

Requirements

What you’ll need

Must hold an active and unrestricted RN License
Must be willing and able to pursue multi-state licensure
Minimum of 3+ years of clinical experience as an RN in a NICU setting
Preferred RN licensure in a compact state
Clinical experience as an RN in an inpatient or outpatient setting focused on women's health, Infertility, maternity and/or OB-GYN office setting
1+ years of Case Management experience in an integrated model
1+ years of experience with Telephonic Case Management
Experience with Microsoft Office, including PowerPoint, Excel, and Word
Certified Case Manager (CCM) certification
Experience with ATV/ASD
Associates Degree Nursing
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 mbs download and 3 mbs upload
Quiet, secure, private designated home virtual 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 simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar (Google Workspace)
Ability to access secure systems such as VPN and EHR portals, maintain strong passwords, and recognize suspicious emails or links
Ability to resolve 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-paid multi-state licensure
Company-provided equipment (keyboard, monitor, computer, headset, etc.)