Case Manager Registered Nurse Job at CVS Health (Roanoke or Rocky Mount)

Case Manager Registered Nurse

CVS Health

Location:
United States , Roanoke or Rocky Mount

Category:
Nursing

Contract Type:
Not provided

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. Nurse Case Manager is responsible for assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long- term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.

Job Responsibility:

Assess, plan, implement and coordinate all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness
Develop a proactive course of action to address issues presented to enhance the short and long- term outcomes as well as opportunities to enhance a member’s overall wellness through integration
Conduct an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans
Apply clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
Reviews prior claims to address potential impact on current case management and eligibility
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management
Utilizes case management processes in compliance with regulatory and company policies and procedures
Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Requirements:

RN with current unrestricted Virginia state licensure required
3 years clinical experience (med surg, behavioral health)
2+ years Managed Care experience
Must reside in Rocky Mount, Martinsville or Surrounding areas
Must possess reliable transportation and be willing and able to travel up to 75% of the time to meet with members face to face
Valid Driver's License
Associates Degree in Nursing required

Nice to have:

Case Management in an integrated model
Bilingual
5 years clinical practice experience
Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
Proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written

What we offer:

$1,000 New Hire Bonus
Mileage is reimbursed per our company expense reimbursement policy
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
February 22, 2026

Expiration:
March 05, 2026

Employment Type:

Fulltime

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