Case Manager, Registered Nurse – Medicare

CVS Health

Case Manager Registered Nurse in Community Care focusing on Medicare members. Collaborating with providers and community organizations to address healthcare needs.

Posted 5/28/2026full-timeRemote • Pennsylvania • 🇺🇸 United StatesMid-LevelSenior💰 $60,522 - $129,615 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.
Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.

Requirements

What you’ll need

Active and unrestricted RN Compact licensure
Minimum 3+ years clinical practical experience preference: (Diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
Minimum 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 multi state RN licenses if needed, company will provide
Certified Case Manager is preferred
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required
Associates degree or Nursing diploma required. Bachelor’s degree preferred.

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
comprehensive benefits package

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical practical experiencecase managementdischarge planninghome health care coordinationanalytical skillsproblem-solving skillsnavigating multiple systemskeyboard skills

Soft Skills

effective communicationorganizational skillsinterpersonal skillsindependent work

Certifications

RN Compact licensureCertified Case ManagerCRCCDMSCRRNCOHNCCM