Case Manager, Registered Nurse

CVS Health

RN Case Manager at CVS Health conducting telephonic assessments and care coordination to enhance member wellness. Requires North Carolina RN license and relevant clinical experience.

Posted 6/19/2026full-timeNorth Carolina • 🇺🇸 United StatesJuniorMid-Level💰 $54,095 - $116,760 per yearWebsite

About the role

Key responsibilities & impact

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.
Conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions.
Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators that impact care planning and resolution of member issues.
Reviews prior claims to address potential impact on current case management and eligibility.
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

What you’ll need

Must have an active and unrestricted RN license in the state of North Carolina.
Multiple State RN licensure is welcomed but not required.
2+ years of clinical experience as an RN
All clinical experience will be considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical / Surgical, Orthopedics, Long Term Care, and Infusion nursing.

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 judgmentcase managementevaluation of member needsrisk factor reductionhealth care planningclaims reviewinterviewing skillsmember engagementbenefit plan eligibilityintegrative functions

Soft Skills

proactive problem solvingcommunicationinterpersonal skillsstrategic thinkingempathycollaborationorganizational skillsanalytical skillsadaptabilityattention to detail

Certifications

active RN licenseunrestricted RN license