Case Manager, RN

CVS Health

. Assess members’ health status and care coordination needs .

Posted 11/6/2026full-timeRemote • North Carolina • United StatesMid-LevelSenior💰 $54,095 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, including conducting comprehensive clinical assessments and developing individualized care plans. Proficient in advocating for patients and promoting quality, cost-effective healthcare outcomes while utilizing data-driven methods.

Highest-signal resume keywords

Active RN License3+ Years Acute Care ExperienceCertified Case Manager (CCM)Telephonic Case Management ExperienceManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentDischarge PlanningData-Driven MethodsMotivational InterviewingPatient AdvocacyQuality ImprovementHealth Literacy AssessmentCoaching and EducationBehavior Change Promotion

Soft Skills

Customer ServiceCollaborationInfluencing SkillsCommunicationProblem-Solving

Tools & Technologies

Microsoft Office 365Google WorkspaceVPNEHR PortalsTeamsVirtual Meetings

Certifications & Qualifications

Certified Case Manager (CCM)Compact RN License

Industry Keywords

Acute CareManaged CareHIPAA ComplianceTelephonic Case ManagementHealthcare Coverage

About the role

Key responsibilities & impact

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 when indicated
Close cases when members meet discharge criteria
Use data-driven methods to identify members for individualized case management programs or alternative healthcare referrals
Conduct comprehensive clinical assessments
Evaluate needs and develop approaches based on member needs, benefit plans, and external programs/services
Advocate for patients within existing healthcare coverage
Promote quality, cost-effective outcomes and suggest program or operational improvements
Identify and escalate quality-of-care issues through established channels
Provide a high level of customer service
Assess health literacy, technology capabilities, and readiness to change
Use influencing and motivational interviewing to engage members and promote lifestyle or behavior changes
Provide coaching, information, education, and support to empower independent medical and healthy-lifestyle choices
Collaborate with members, healthcare resources, and the Medical Director as appropriate

Requirements

What you’ll need

Active, current, and unrestricted RN license in state of residence
Willingness and ability to obtain additional state licenses upon hire
3+ years of acute care experience as an RN
Willingness and ability to work Monday through Friday, 8:00am–4:30pm in the time zone of residence, with an occasional late shift rotation of 11:00am–8:00pm EST once per quarter
Associate Degree required
Compact RN License or multi-state licensure preferred
Certified Case Manager (CCM) preferred
Managed Care experience preferred
Hospital experience in ICU, CCU, Step Down, ER, or OR preferred
Telephonic case management and/or telephonic experience preferred
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
Must work within the state and city where currently living
Ability to provide own workspace furniture
Ability to use multiple monitors and navigate multiple applications
Ability to use email, calendar invites, Teams, virtual meetings, and Microsoft Office 365 or similar Google Workspace applications
Ability to access secure systems such as VPN and EHR portals, maintain strong passwords, and recognize suspicious emails or links
Ability to troubleshoot 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 (keyboard, monitor, computer, headset, etc.)
Company-paid additional state licenses obtained after hire
Flexible work from home arrangement