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Case Manager - Registered Nurse - Southeast Region

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Work at Home

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Category:
Nursing

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Contract Type:
Employment contract

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Salary:

60522.00 - 129615.00 USD / Year
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Job Description:

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.

Job Responsibility:

  • Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
  • Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
  • Interacts with members/clients telephonically or in person
  • Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
  • Develops a plan of care to facilitate the member/client's appropriate condition management
  • Communicates with member/client and other stakeholders as appropriate
  • Prepares all required documentation of case work activities as appropriate
  • Interacts and consults with internal multidisciplinary team as indicated
  • May make outreach to treating physician or specialists concerning course of care and treatment
  • Provides educational and prevention information for best medical outcomes
  • Applies all laws and regulations that apply to the provision of rehabilitation services
  • Conducts an evaluation of members/clients' needs and benefit plan eligibility
  • Utilizes case management processes in compliance with regulatory and company policies
  • Facilitates appropriate condition management, optimize overall wellness and medical outcomes
  • Develops a proactive course of action to address issues presented
  • Monitors member/client progress toward desired outcomes through assessment and evaluation

Requirements:

  • Candidates must live in the Southeast Region (States Include- FL, GA, AL, MS, NC, SC, TN, AR, LA)
  • Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence
  • 3+ years clinical practical experience with preference in the following areas: diabetes, Congestive Heart Failure (CHF), Chronic Kidney Disease (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members
  • 2+ years case management, discharge planning and/or home health care coordination experience
  • 2+ years of experience with Microsoft Word, Excel, and Outlook
  • Associate's Degree in Nursing or Nursing Diploma (REQUIRED)

Nice to have:

  • Previous work from home experience in a healthcare related field
  • Excellent analytical and problem-solving skills
  • Effective communications, organizational, and interpersonal skills
  • Ability to work independently
  • Certified Case Manager National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
  • Efficient and effective computer skills including navigating multiple systems and keyboarding
  • Bachelor's Degree in Nursing
What we offer:
  • Medical
  • Dental
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Eligible for CVS Health bonus, commission or short-term incentive program

Additional Information:

Job Posted:
May 15, 2026

Expiration:
May 27, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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