Case Manager, RN

CVS Health

. Telephonically assess, plan, implement, and coordinate case management activities with members .

Posted 11/4/2026full-timeRemote • United StatesJuniorMid-Level💰 $60,522 - $129,615 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management activities, including assessment, planning, and coordination of care for members, while applying clinical judgment to improve health outcomes. Holds active RN licensure and possesses strong clinical experience across various healthcare settings.

Highest-signal resume keywords

Active RN LicensureCertified Case Manager (CCM)Clinical Experience as an RNCase Management in an Integrated ModelMicrosoft Office Suite Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentDischarge PlanningHolistic ApproachRisk Factor ReductionCo-Morbidity AssessmentData ReviewClinical JudgmentHealth Status EvaluationReferral Determination

Soft Skills

Interpersonal SkillsCommunication SkillsCollaborationProblem-SolvingEngagement Skills

Certifications & Qualifications

Certified Case Manager (CCM)

Industry Keywords

Managed CareEmergency DepartmentHome HealthHospiceOperating RoomICUNICUTelemetryMedical/SurgicalLong Term Care

About the role

Key responsibilities & impact

Telephonically assess, plan, implement, and coordinate case management activities with members
Evaluate members’ medical needs to facilitate overall wellness
Develop proactive courses of action to improve short- and long-term outcomes
Review clinical tools, information, data, prior claims, benefit eligibility, work capacity, and restrictions
Facilitate transitions to Aetna programs and plans
Apply clinical judgment to reduce risk factors and address complex health and social indicators
Assess co-morbidities and multiple diagnoses affecting functionality
Use a holistic approach to determine referrals to clinical resources
Consult with supervisors and colleagues to overcome barriers
Present cases at multidisciplinary case conferences
Follow regulatory and company case management policies and procedures
Use interviewing skills to engage members and determine health status and needs

Requirements

What you’ll need

Active, current and unrestricted RN licensure in the state of residence
Multiple State RN licensure welcomed but not required; willingness and ability to obtain multiple state RN licensure after hire if chosen
2+ years of clinical experience as an RN
3+ years’ experience with Microsoft Office Suite
Willingness and ability to work Monday through Friday, 9:00am–5:30pm EST
Willingness and ability to work occasional evening, weekend, and holiday shifts as needed
Associates Degree required
Certified Case Manager (CCM) certification preferred
Case Management in an integrated model preferred
Discharge Planning experience preferred
Managed care experience preferred
Clinical experience in areas such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical/Surgical, Orthopedics, Long Term Care, or Infusion nursing considered

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to the base pay range
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 expenses for multiple-state RN licensure obtained after hire