Care Manager, RN – Field

CVS Health

Community Care Case Manager improving health outcomes by facilitating care and benefits for members. Working with a collaborative team at CVS Health to enhance patient care in local communities.

Posted 7/29/2026full-timeNew Haven • Connecticut • 🇺🇸 United StatesMid-LevelSenior💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in case management processes, including assessment, planning, and coordination of care for chronically ill members. Proficient in applying healthcare regulations and delivering effective communication to optimize member wellness and outcomes.

Highest-signal resume keywords

Active CT LicenseClinical Experience with Medicare MembersCase Management ExperienceRegistered NurseCertified Case Manager

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Case Management ProcessesCondition ManagementAssessment and EvaluationDocumentation PreparationHealthcare Policy Implementation

Soft Skills

Analytical SkillsProblem-Solving SkillsEffective CommunicationOrganizational SkillsInterpersonal Skills

Tools & Technologies

MS WordMS ExcelMS OutlookMS PowerPointProprietary Applications

Certifications & Qualifications

Registered NurseCertified Case ManagerAdditional National Professional Certifications

Industry Keywords

Chronic Illness ManagementHome Health Care CoordinationDischarge PlanningWellness ActivitiesMedicare Compliance

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/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 that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services.
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.
Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
Prepares all required documentation of case work activities as appropriate.
Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.
Provides educational and prevention information for best medical outcomes.
Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.
Testifies as required to substantiate any relevant case work or reports.
Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
Utilizes case management processes in compliance with regulatory and company policies and procedures.
Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.
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/client’s overall wellness through integration.
Monitors member/client progress toward desired outcomes through assessment and evaluation.

Requirements

What you’ll need

Active and unrestricted CT license
Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
Minimum 2+ years CM, discharge planning and/or home health care coordination experience
Registered Nurse with active state license in good standing within the region where job duties are performed is required.
Ability to occasionally travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
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.
Bachelor’s degree preferred.
Certified Case Manager is preferred.
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required.

Benefits

Comp & perks

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