Case Manager, Registered Nurse (Remote)

CVS Health; Oregon; Hybrid; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Nurse Case Manager to deliver comprehensive case management services through telephonic and face-to-face interactions. You will assess, plan, implement, and coordinate care strategies to support members' medical needs and promote overall wellness.

Responsibilities include evaluating eligibility, developing proactive care plans, reviewing prior claims, and coordinating referrals with clinical resources.

Qualifications

• Active RN license in the state of residence; willing to obtain additional state licenses (paid by the company).
• 3+ years' experience in acute care and/or case management.
• 2+ years' Med/Surg experience.
• Must be willing to work Monday-Friday 8:00am-4:30pm local time zone.

Responsibilities

• Deliver comprehensive case management services via telephonic and/or face-to-face interactions.
• Assess, plan, implement and coordinate care strategies to support members' medical needs.
• Evaluate member eligibility, health risks and develop proactive care plans.
• Review prior claims and coordinate referrals to clinical resources; collaborate with multidisciplinary teams.

Skills

Telephonic communication

Time management

Education

Associate's Degree in Nursing

RN License

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

The Nurse Case Manager is responsible for delivering comprehensive case management services through telephonic and/or face-to-face interactions. This role involves assessing, planning, implementing, and coordinating care strategies to support members' medical needs and promote overall wellness. This role operates within established regulatory and organizational policies, applying case management processes and service strategies that align with network management and clinical coverage guidelines. Strong interviewing and engagement skills are critical to understanding member needs and facilitating smooth transitions to appropriate programs and services.

What you will do

Utilize clinical judgment and data-driven tools to evaluate member eligibility, identify health risks, and develop proactive care plans that address both short- and long-term health outcomes. Conduct holistic assessments that consider co-morbid conditions, functional limitations, and social determinants of health. Review prior claims, evaluate work capacity, and determine the need for referrals to clinical resources. Collaborate with supervisors and multidisciplinary teams is essential to overcome barriers and optimize care planning.

Required Qualifications

• An active and unrestricted RN license in the state of residence. Willing and able to obtain additional state licenses upon hire. (Paid for by the company)
• 3+ years' experience of acute care and/or case management.
• 2+ years' Med/Surg experience.
• Must be willing to work Monday-Friday 8:00am-4:30pm local time zone.

Preferred Qualifications

• Prefer candidate in PST Zone.
• Behavioral Health experience.
• Certified Case Manager.
• Managed care experience.
• Strong telephonic communication skills.
• Ability to manage multiple priorities, effective organizational, and time management skills.
• Ability use a computer station and sit for extended periods of time.

Education and Licensing

Associate's Degree in Nursing. RN License in your state of residence.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $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.

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: 11/12/2026

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

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people.

Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.