Case Manager, Registered Nurse – Oncology Experience Required

CVS Health

Telephonic Case Manager role focusing on Oncology patients. Supporting members across states while ensuring quality care for CVS Health.

Posted 5/6/2026full-timeRemote • Idaho, Montana, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $54,095 - $155,538 per yearWebsite

About the role

Key responsibilities & impact

work intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients
application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member’s needs
apply clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators
assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality
consult with supervisor and others in overcoming barriers in meeting goals and objectives
present cases at case conferences for multidisciplinary focus
consult with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives
utilize case management processes in compliance with regulatory and company policies and procedures
utilize motivational interviewing skills to ensure maximum member engagement
identify and escalate member’s needs appropriately following set guidelines and protocols
actively reach out to members to collaborate/guide their care
perform medical necessity reviews

Requirements

What you’ll need

5+ years’ experience as a Registered Nurse, including at least 1 year in a hospital setting
A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC)
Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support
1+ years’ experience documenting electronically using a keyboard
1+ years’ current or previous experience in Oncology
1+ years’ Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience preferred
1+ years' experience in Utilization Review preferred
CCM and/or other URAC recognized accreditation preferred
1+ years’ experience with MCG, NCCN and/or Lexicomp preferred
Bilingual in Spanish preferred
Bachelors Degree Education Diploma or Associates Degree in Nursing required

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

Registered NurseOncologyCase ManagementUtilization ReviewMedical Necessity ReviewsMotivational InterviewingDocumentationNurse NavigatorNurse Care CoordinatorDischarge Planning

Soft Skills

Clinical JudgmentCollaborationCommunicationProblem SolvingInterpersonal SkillsEngagementConsultationAssessmentGoal SettingOvercoming Barriers

Certifications

Registered Nurse LicenseCCMURAC Accreditation