Remote RN Case Manager — Integrated Care & Utilization

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

Benefits offered by this job

100% remote

Comprehensive benefits

Multi-state licensure

Job summary

CVS Health Corporation is seeking a remote RN Case Manager in the United States. This blended role combines Case Management and Utilization Management to support members with complex healthcare needs.

You will work with members, providers, and interdisciplinary teams to create personalized care plans and promote better health outcomes. Requirements include an active Compact RN license, 5+ years of RN clinical practice, 2+ years in critical care, and 6+ months in Case/Utilization Management.

Qualifications

• Active, unrestricted Compact RN license in state of residence.
• 5+ years of RN clinical practice experience.
• 2+ years of critical care experience.
• 6+ months of Case Management or Utilization Management experience.
• Ability to work Monday-Friday, 8:00 AM-5:00 PM in your local time zone.
• Willingness to obtain additional state RN licenses (company-paid).

Responsibilities

• Assess, coordinate, and manage care for members with complex medical needs.
• Develop proactive care plans to improve short- and long-term health outcomes.
• Identify clinical, social, and functional barriers impacting care.
• Collaborate with healthcare providers and multidisciplinary teams.
• Utilize clinical judgment to support utilization and care management decisions.
• Engage members through telephonic care management and health coaching.

Skills

Compact RN license

RN clinical practice

Critical care experience

Case Management

Utilization Management

Telephonic care management

Education

Associate Degree in Nursing

BSN preferred

Job description

CVS Health Corporation is seeking a remote RN Case Manager in the United States. This blended role combines Case Management and Utilization Management to support members with complex healthcare needs.

You will work with members, providers, and interdisciplinary teams to create personalized care plans and promote better health outcomes. Requirements include an active Compact RN license, 5+ years of RN clinical practice, 2+ years in critical care, and 6+ months in Case/Utilization Management.