Care Manager - Registered Nurse

CVS Health; New Albany (OH); Remote; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a remote Case Manager RN to assess, plan, implement and coordinate case management to promote member wellness. The role supports telephonic and face-to-face interactions across the United States.

Requires an active RN license and 5+ years of acute care experience, with Monday–Friday, 40 hours weekly in the residence time zone and occasional late shifts. CVS Health offers comprehensive benefits and incentive programs.

Qualifications

• Active RN license required in state of residence.
• 5+ years of acute care experience as an RN.
• Willingness to work 8:00am–4:30pm in residence time zone, with occasional late shifts.
• Strong computer and Microsoft Office skills.

Responsibilities

• Telephonically and/or face-to-face assessing, planning and coordinating case management.
• Evaluate members’ medical needs to facilitate overall wellness.
• Apply clinical judgment to reduce risk factors and address barriers to care.
• Navigate benefits, eligibility and transitions to appropriate programs.

Skills

Computer skills

Microsoft Office

Education

Associate's degree in Nursing with RN licensure

BSN preferred

Job description

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

This Case Manager RN position is 100% remote, allowing candidates to reside in any U.S. state. Positions are available across all time zones, with preference for Pacific Standard Time.

Normal Working Hours

Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation per the needs of the business 10:30am-7pm EST (1-2 times per quarter). Typical training hours are Monday-Friday 8-4:30 EST.

Nurse Care Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

• 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.
• Services strategies policies and programs are comprised of network management and clinical coverage policies.
• Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member’s level of work capacity and related restrictions/limitations.
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes MI skills to ensure maximum member engagement and discern their health status.

Required Qualifications

• Must have an active current and unrestricted Registered Nurse license in state of residence. With the willingness and ability to obtain additional state licenses upon hire (paid for by the company)
• 5+ years of acute care experience as an RN
• Must be willing and able to work Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation per the needs of the business 10:30AM to 7PM EST
• Strong computer skills
• Microsoft Suite familiarity

Preferred Qualifications

• Compact State licensure
• CCM certification
• Experience in care case management
• Home Care experience
• Spanish speaking/bilingual
• Oncology experience/background

Education

Associate's with RN licensure, required; BSN, preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$60,522.00 - $129,615.00

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.