Case Manager RN

4062 Aetna Resources, LLC; Pennsylvania; Hybrid; USD 61.000 - 130.000; Vollzeit

Zusammenfassung

CVS Health is hiring for a 100% remote RN Case Manager position. You will conduct telephonic assessments, build individualized care plans, and coordinate care across providers to improve health outcomes. This role supports a nationwide remote schedule with weekday hours and occasional late shifts.

Prior case management and CCM certification are preferred. Full-time remote opportunity with company-sponsored multi-state licensure options, and a focus on HIPAA-compliant, secure remote work

Qualifikationen

• Active, unrestricted RN license in your state of residence.
• Ability to obtain multi-state/compact licensure (company-paid).
• 3+ years of clinical nursing experience.
• 1+ year of experience using Microsoft Office (Outlook, Word, Excel).
• BSN preferred.

Aufgaben

• Conduct telephonic assessments to evaluate members' medical, behavioral, and social needs.
• Develop individualized care plans that support improved health outcomes and overall wellness.
• Identify barriers to care and implement strategies to reduce risk and improve member engagement.
• Coordinate care across providers, programs, and community resources.
• Review clinical information, claims history, and benefit eligibility to support appropriate interventions.
• Utilize motivational interviewing and clinical judgment to engage members and support goal achievement.
• Collaborate with multidisciplinary teams to address complex cases and facilitate optimal outcomes.
• Ensure compliance with regulatory requirements and company case management standards.

Kenntnisse

RN license

Multi-state licensure

Clinical nursing experience

Time management

Ausbildung

Associate Degree in Nursing

BSN preferred

Tools

Microsoft Office

Jobbeschreibung

Remote RN Case Manager 100% Remote | Nationwide Opportunity | Monday–Friday Schedule

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.

What You'll Do

• Conduct telephonic assessments to evaluate members' medical, behavioral, and social needs
• Develop individualized care plans that support improved health outcomes and overall wellness
• Identify barriers to care and implement strategies to reduce risk and improve member engagement
• Coordinate care across providers, programs, and community resources
• Review clinical information, claims history, and benefit eligibility to support appropriate interventions
• Utilize motivational interviewing and clinical judgment to engage members and support goal achievement
• Collaborate with multidisciplinary teams to address complex cases and facilitate optimal outcomes
• Ensure compliance with regulatory requirements and company case management standards

What You Bring — REQUIRED

• Active, unrestricted RN license in your state of residence
• Ability to obtain multi-state/compact licensure (company-paid)
• 3+ years of clinical nursing experience
• 1+ year of experience using Microsoft Office (Outlook, Word, Excel)
• Ability to work Monday–Friday with schedules starting as early as 8:00 AM in your local time zone
• Ability to participate in rotating late shifts (up to 8:00 PM EST) and holiday on‑call coverage as needed

Preferred Qualifications

• Compact RN license
• Case Management experience
• Case Manager Certification (CCM or equivalent)
• BSN preferred

Schedule & Work Environment

• Fully remote; candidates from any U.S. state are welcome to apply
• No travel required
• Standard schedule: Monday–Friday, 8:00 AM–4:30 PM in your local time zone
• Occasional late‑shift rotation and holiday on‑call support
• Education: Associate Degree in Nursing required, BSN preferred

Why Join Us?

• Work from anywhere in the U.S.
• No travel requirements
• Make a direct impact on member health and wellness
• Collaborate with an experienced interdisciplinary team
• Expand your case management expertise in a supportive environment
• Company-sponsored multi‑state licensure opportunities

Work from Home Requirements

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
• A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
• Work‑from‑Home colleagues are required to work within the state and city where they have confirmed they currently live.
• The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
• If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements

• Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
• Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
• Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
• Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
• Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
• Future Growth: Openness to learning new skills in the future as the workplace environment evolves.

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.

Benefits

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.

Application Period

We anticipate the application window for this opening will close on: 10/13/2026

EEO & Eligibility

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

Culture & Company

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.