Case Manager Registered Nurse Job at CVS Health (Work at Home)

Case Manager Registered Nurse

CVS Health

Location:
United States , Work at Home

Category:
Nursing

Contract Type:
Employment contract

Salary:

Not provided

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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
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
develops a plan of care
Communicates with member/client and other stakeholders telephonically or in person
Prepares all required documentation of case work activities
Interacts and consults with internal multidisciplinary team
May make outreach to treating physician or specialists
Provides educational and prevention information
Applies all laws and regulations
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
Develops a proactive course of action
Monitors member/client progress toward desired outcomes

Requirements:

Active and unrestricted Registered Nurse License in East Coast States
Minimum 3+ years clinical practical experience with Medicare members (specifically diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac members)
Minimum 2+ years CM, discharge planning and/or home health care coordination experience
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently

Nice to have:

Bilingual
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM)
Compact RN license or willing and able to obtain multi-state RN licenses if needed

What we offer:

Medical
dental
vision coverage
paid time off
retirement savings options
wellness programs
other resources
bonus, commission or short-term incentive program

Additional Information:

Job Posted:
April 24, 2026

Expiration:
May 01, 2026

Employment Type:

Fulltime

Work Type:

Remote work

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