Case Manager Registered Nurse
CVS HealthAbout the role
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
Plan Sponsor business hours : Monday through Friday 7:00am to 6:00pm CST. There are currently no nights, no weekends, and no holidays; however, it is subject to change based on business needs. Your schedule must be 8 hours within this time frame and can include either a 30 or 60 min unpaid lunch.
The RN Case Manager plays a vital role in supporting members through telephonic assessment, care coordination, and strategic planning. This position focuses on evaluating each member’s medical needs and helping facilitate their overall wellness through a comprehensive, person‑centered approach.
Key Responsibilities
- Conduct telephonic assessments and develop proactive, individualized care plans to improve both short‑ and long‑term health outcomes.
- Use clinical tools, data insights, and benefit plan knowledge to evaluate member needs and ensure smooth integration across programs and services.
- Apply clinical judgment to identify and address risk factors, barriers to care, and complex medical or social issues that influence health outcomes.
- Complete holistic assessments that consider co‑morbid conditions, multiple diagnoses, functional limitations, and prior claims that may impact current care planning.
- Evaluate each member’s level of work capacity, including any restrictions or limitations.
- Determine the need for referrals to internal or external clinical resources using a whole‑person approach.
- Collaborate with supervisors and multidisciplinary teams to overcome barriers, discuss challenging cases, and promote high‑quality care coordination.
- Adhere to case management processes and maintain compliance with all regulatory and organizational policies and procedures.
- Utilize strong interviewing and engagement skills to build rapport, understand health needs, and support members in navigating their care.
Required Qualifications
Must have an active, current and unrestricted RN licensure in the state of residence and be willing to apply for a Compact RN (fees pd by company)
5 years clinical practice experience as an RN
Must be able to work Monday through Friday between the hours of 7:00am to 6:00 pm CST. There are currently no nights, no weekends, and no holidays; however, it is subject to change based on business needs.
Preferred Qualifications
6+ months Case Management or Utilization Management experience
Case Management Certification
Education
Associate Degree required
BSN preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,522.00 - $129,615.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contribut
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