Case Manager

CVS Health Corporation; Boise (ID); On-site; USD 54,000 - 117,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation in Boise, Idaho seeks a Registered Nurse Case Manager to telephonically and/or face-to-face assess, plan, implement, and coordinate case management activities for members. The role supports wellness, eligibility checks, and integration with Aetna programs.

Requires active RN licensure, 3+ years of clinical experience, and strong computer skills; familiarity with Windows/Microsoft Office and bilingual English/Spanish is a plus. Full-time with a robust benefits package.

Qualifications

• RN licensure active and unrestricted in resident state; multi-state/compact preferred
• Minimum of 3+ years clinical practice experience required
• Compact RN licensure preferred
• Case management experience preferred
• Case Manager Certification preferred
• Experience with Windows / Microsoft Office required
• Bilingual English/Spanish is a plus

Responsibilities

• Assess member health needs telephonically and face-to-face to coordinate care
• Develop proactive care plans to improve short- and long-term outcomes
• Review prior claims to assess impact on care and eligibility
• Coordinate referrals to clinical resources and other programs
• Ensure compliance with regulatory and company policies
• Engage members to understand health status and barriers to care
• Collaborate with supervisor and team on cases and challenges to improve outcomes

Skills

Bilingual English/Spanish

Strong computer skills

Education

Associate's degree

Bachelor’s degree preferred

Tools

Windows / Microsoft Office

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.

Normal Working Hours

Monday through Friday 8:00am through 5:00pm in time zone of residence. Rotation for 8pm EST.

The RN Case 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.

RN Case Manager:

• 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.
• 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 consider 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 interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications

• Registered Nurse with active and unrestricted RN licensure in their state of residence, preferably with multi-state/compact privileges. Must have the ability to be licensed in all non-compact states
• 3+ years clinical practice experience required

Preferred Qualifications

• Compact RN licensure
• Case management experience
• Case Manager Certification
• Experience with using Windows / Microsoft Office
• Strong computer skills
• Bilingual(English/Spanish) speaking

Education

• Associate's degree required, Bachelor’s degree preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$54,095.00 - $116,760.00

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: 10/26/2026

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