Case Manager, RN

CVS Health

. Assess members’ health status and care coordination needs .

Posted 10/12/2026full-timeRemote • Ohio • 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 clinical assessments, developing care plans, and advocating for patients. Proficient in utilizing data-driven methods for individualized care and promoting quality outcomes within healthcare coverage.

Highest-signal resume keywords

Active RN LicenseCertified Case Manager (CCM)3+ Years Acute Care ExperienceTelephonic Case Management ExperienceManaged Care Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementClinical AssessmentCare CoordinationDischarge PlanningMotivational InterviewingHealth Literacy AssessmentData-Driven MethodsPatient AdvocacyQuality ImprovementBehavior Change Promotion

Soft Skills

Customer ServiceCommunicationCoachingInfluencingEmpowerment

Tools & Technologies

Microsoft Office 365Google WorkspaceVPN AccessEHR PortalsMultiple Monitors

Certifications & Qualifications

Active RN LicenseCertified Case Manager (CCM)

Industry Keywords

Managed CareAcute 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 as indicated and close cases when discharge criteria are met
Identify members using data-driven methods for individualized case management programs or alternative healthcare referrals
Conduct comprehensive clinical assessments
Evaluate needs and develop approaches based on member needs, benefit plans, or external programs and services
Advocate for patients within existing healthcare coverage
Promote quality, cost-effective outcomes and suggest program or operational efficiency improvements
Identify and escalate quality-of-care issues
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

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 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 multistate 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 modem/router within 7 feet of computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
WiFi and satellite internet are not permitted
Quiet, secure, private designated home 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 simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 applications or similar Google Workspace applications
Ability to access secure systems such as VPN and EHR portals
Ability to follow computer security and password practices 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.)
Additional state licenses paid for by the company