Case Manager Registered Nurse - Field

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary This Case Manager (Registered) role supports Aetna's Long-Term Services and Supports (LTSS) team and is a field‑based position serving the Western Richmond, Virginia region. Candidates must hold a current Virginia Registered Nurse (RN) or Licensed Practical Nurse (LPN) license and be able to travel 50-75% of the time to conduct in‑person member visits.

The position includes periods of remote/office‑based work with productivity and quality expectations. Work involves reviewing handwritten and computer‑generated documentation, using a PC for extended periods, and engaging in frequent phone and virtual communication.

Role Overview The Case Manager is responsible for assessing, planning, coordinating, and implementing comprehensive case management services to support members' medical, functional, and social needs. The goal is to enhance both short‑term and long‑term wellness outcomes through proactive care planning and integrated support strategies.

Key responsibilities include:

Conducting holistic assessments using clinical tools, data review, and member interviews to determine needs, benefit eligibility, and care coordination requirements.

Developing individualized care plans to address medical, behavioral, and social factors impacting member health.

Identifying risk factors, barriers, and opportunities to improve wellness and reduce health complications.

Collaborating closely with internal and external partners to support seamless transitions into Aetna programs and services.

Reviewing claims history and clinical information to guide care decisions and evaluate potential case management impact.

Presenting complex cases in multidisciplinary conferences and consulting with supervisors to overcome barriers to goals.

Ensuring compliance with company policies, regulatory requirements, and case management standards.

Using effective interviewing and engagement techniques to understand member needs and encourage active participation in their care plan.

Required Qualifications Must reside to the West of Richmond Virginia, including areas such as Ashland, Glen Allen, Henrico and Tuckahoe.

Reliable transportation and willingness to travel 50-75% of the time (mileage reimbursement provided per company policy).Current, unrestricted Virginia LPN, RN, or Behavioral Health license.

Minimum 3 years of clinical experience (ideally in Medical‑Surgical, Behavioral Health, Long‑Term Care, or related settings).1+ year of Managed Care experience.

Proficiency in navigating multiple computer systems, strong keyboarding skills, and ability to work in a technology‑driven environment.

Preferred Qualifications Case Management experience within an integrated care model.
5+ years of clinical practice.

Strong ability to multitask, prioritize, and adapt in a fast‑paced, evolving environment.

Excellent verbal and written communication skills.

Bilingual (Spanish) strongly preferred.

Education Associate's Degree required

Bachelor's Degree preferred

Anticipated Weekly Hours
40

Time Type Full time

Pay Range The typical pay range for this role is:$60,522.00 - $This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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