Case Manager RN

Case Manager RN at CVS Health is a fully remote position with no travel required.

At CVS Health, we’re building a world of health around every consumer, caring for people where, when, and how they choose. We serve millions of Americans through a local presence, digital channels, and more than 300,000 purpose‑driven colleagues.

This case manager role utilizes a collaborative process of assessment, planning, facilitation, and advocacy to meet individual members’ benefit plans and health needs. Responsibilities include assessment, care coordination, inpatient review, discharge planning, and the implementation and monitoring of case management plans in partnership with the Medical Director.

• Apply data‑driven methods of identifying members to fashion individualized case management programs and referrals to alternative healthcare services.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans, or external programs.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost‑effective outcomes and suggest improvements to program and operational efficiency.
• Identify and escalated quality of care issues through established channels.
• Provide a very high level of customer service.
• Utilize assessment techniques to determine member’s health literacy, technology capabilities, and readiness to change.
• Use influencing/motivational interviewing skills to ensure maximum engagement and promote lifestyle/behavior changes for optimum health.
• Provide coaching, information, education, and support to empower members to make independent medical and healthy lifestyle choices.

• Active and unrestricted RN license in the state of residence, with ability to obtain multi‑state licensure upon hire.
• 3+ years of acute care experience as an RN.
• 3+ years of experience with Microsoft Suite of products.

• Compact RN License.
• Certified Case Manager (CCM).
• Case Management experience.
• Managed Care experience.
• Telephonic case management and/or telephonic customer service center experience.
• 2+ years of Oncology Care experience.

• Minimum of Associate Degree in Nursing required.
• BSN preferred.

40

Full Time

$54,095.00 – $ (base hourly rate or full‑time salary, subject to experience, education, geography, and other factors). Eligible for bonus or incentive programs.

• Affordable medical plan options, 401(k) with company match, and employee stock purchase plan.
• No‑cost wellness programs: screenings, tobacco cessation, weight management, counseling, and financial coaching.
• Benefit solutions addressing diverse needs: paid time off, flexible schedules, family leave, dependent care, assistance programs, tuition assistance, retiree medical access, and more.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.

We anticipate the application window for this opening will close on: 01/15/2026.