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Case Manager RN- San Antonio, TX

Hispanic Alliance for Career Enhancement

Town of Texas (WI)

Remote

USD 60,000 - 130,000

Full time

Today
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Job summary

A leading health solutions company is seeking a Case Manager RN to assess and coordinate care for members. This fully remote role requires strong clinical skills, active multi-state RN licensure in Texas, and 3+ years of nursing experience. The successful candidate will work Monday through Friday, with occasional flexibility in hours. Benefits include competitive pay and a robust medical plan.

Benefits

Affordable medical plan options
401(k) plan with matching
Tuition assistance

Qualifications

  • Must have active current and unrestricted RN multi state licensure in Texas.
  • 3+ years clinical practice experience as an RN required.
  • 1+ year(s) experience utilizing multiple computer systems and applications.

Responsibilities

  • Conduct assessments and evaluations of member's needs.
  • Develop a proactive course of action to enhance member wellness.
  • Facilitate transitions to Aetna programs and plans.

Skills

Active RN multi state licensure in Texas
3+ years clinical practice experience as an RN
Experience with Microsoft Word, Excel, Outlook
Bilingual in Spanish and English

Education

Associates Degree
BSN preferred
Job description
Overview

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues — caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. We do it all with heart, each and every day.

Position Summary

This Case Manager RN role is with the Costco Team and is fully remote; however, candidates must reside within 45 minutes (reasonable driving distance) from the local office located at 7034 Alamo Downs Pkwy, San Antonio, TX 78238.

Scheduled - Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion when required to meet business needs. No weekends or holidays will be required.

The Case Manager RN 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. The Case Manager RN 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.

The Case Manager RN job duties include (not an all-encompassing list):

  • 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
  • Must have active current and unrestricted RN multi state licensure in Texas
  • Willingness to obtain additional state licenses will be required upon hire (expenses will be covered by company).
  • 3+ years clinical practice experience as an RN required
  • 1+ year(s) experience utilizing multiple computer systems and applications including Microsoft Word, Excel, Outlook, and web-based applications
  • Must reside within 45 minutes (reasonable driving distance) from the local office located at 7034 Alamo Downs Pkwy, San Antonio, TX 78238.
  • Travel to the San Antonio office may be required for quarterly meetings or PRN meetings.
  • Must be able to work Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion when required to meet business needs.
Preferred Qualifications
  • Case Management in an integrated model
  • Bilingual in Spanish and English
  • Strong computer skills
Education
  • Associates Degree required
  • BSN preferred
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

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.

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 10/14/2025

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

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