Case Manager – Registered Nurse

CVS Health

Community Care Case Manager in CVS Health undertaking compassionate care management for members. Collaborating with health care teams and providers to promote wellness and effective outcomes.

Posted 5/5/2026full-timeRemote • New Jersey • 🇺🇸 United StatesMid-LevelSenior💰 $60,522 - $142,576 per yearWebsite

About the role

Key responsibilities & impact

Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work
Acts as a liaison with member, family, 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 that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care
Interacts with members/clients telephonically
Assesses and analyzes injured, acute, or chronically ill members medical; develops a plan of care to facilitate the member appropriate condition management to optimize wellness and medical outcomes, or optimal functioning

Requirements

What you’ll need

Candidate must have active and unrestricted Compact Registered Nurse (RN) License in their state of residence
3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
2+ years case management, discharge planning and/or home health care coordination experience
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently (may require working from home)
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Efficient and effective computer skills including navigating multiple systems and keyboarding
Willing and able to obtain single state Registered Nurse (RN) licensure if needed
Bilingual Certified Case Manager
National professional certification (CRC, CDMS, CRRN, COHN, or CCM)

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

case managementdischarge planninghome health care coordinationclinical practical experiencecondition managementwellness activitieshealth strategiespolicy developmentmedical assessmentproblem-solving

Soft Skills

analytical skillseffective communicationorganizational skillsinterpersonal skillsindependent work

Certifications

Compact Registered Nurse (RN) LicenseBilingual Certified Case ManagerCRCCDMSCRRNCOHNCCM