Case Manager - Registered Nurse

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

Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. 

Family Summary/Mission 

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. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. 

Position Summary/Mission 

Community Care Case Manager 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. 

Required Qualifications

• Candidate must have an active and unrestricted Compact Registered Nurse (RN) license in the state of residence 
• 5+ years clinical practical experience preference: (diabetes, congestive heart failure (CHF), chronic kidney disease (CKD), post-acute care, hospice, palliative care, cardiac) with Medicare members
• 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 Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
• Efficient and effective computer skills including navigating multiple systems and keyboarding

Preferred Qualifications

• Candidate must be willing obtain additional state Registered Nurse (RN) licenses if needed, company will provide
• Bilingual
• Certified Case Manager
• National professional certification (CRC, CDMS, CRRN, COHN, or CCM)

Education

• Associate's Degree or Nursing Diploma (REQUIRED)
• Bachelor’s Degree (PREFERRED)

License

• Active and unrestricted Compact Registered Nurse (RN) license in state of residence

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $142,576.00

This 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 wage