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Case Manager, RN
CVS Health. Conduct telephonic assessments of members’ medical, behavioral, and social needs .
About the role
Key responsibilities & impact- Conduct telephonic assessments of members’ medical, behavioral, and social needs
- Develop individualized care plans to improve health outcomes and wellness
- Identify barriers to care and implement risk-reduction and member-engagement strategies
- Coordinate care across providers, programs, and community resources
- Review clinical information, claims history, and benefit eligibility
- Use motivational interviewing and clinical judgment to engage members and support goal achievement
- Collaborate with multidisciplinary teams on complex cases
- Ensure compliance with regulatory requirements and company case management standards
- Work Monday–Friday on a standard 8:00 AM–4:30 PM local-time schedule
- Provide occasional late-shift rotation and holiday on-call support
Requirements
What you’ll need- Active, unrestricted RN license in your state of residence
- Ability to obtain multi-state/compact licensure
- 3+ years of clinical nursing experience
- 1+ year of experience using Microsoft Office (Outlook, Word, Excel)
- Ability to work Monday–Friday with schedules starting as early as 8:00 AM in your local time zone
- Ability to participate in rotating late shifts up to 8:00 PM EST and holiday on-call coverage as needed
- 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 virtual work location compliant with CVS Health and HIPAA guidelines
- Must work within the state and city where currently living
- Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously
- Ability to use email, calendar invites, Teams messaging, and virtual meetings
- Experience with Microsoft Office 365 applications or similar Google Workspace tools
- Ability to log in to secure systems such as VPN and EHR portals, secure devices, manage strong passwords, and recognize suspicious emails or links
- Ability to resolve common technical issues independently
- BSN preferred
- Compact RN license preferred
- Case Management experience preferred
- Case Manager Certification (CCM or equivalent) preferred
Benefits
Comp & perks- Company-paid ability to obtain multi-state/compact licensure
- Company-sponsored multi-state licensure opportunities
- No travel required
- Company-provided equipment (keyboard, monitor, computer, headset, etc.)
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being