Remote RN Case Manager – LTSS & Home Health

CVS Health; Lansing (MI); Remote; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking an LTSS RN Case Manager to assess, plan, coordinate, and monitor care for dual‑eligible Medicare and Medicaid members. The role includes in‑home visits, waiver coordination, and development of person-centered service plans.

Travel 25–50% across Wayne/Macomb counties, with a 40-hour work week and standard business hours. Qualified candidates hold an active Michigan RN license, with 2+ years nursing and 1+ year case management experience.

Qualifications

• Active RN license in Michigan.
• 2+ years clinical nursing experience.
• 1+ year in case management or related field.
• Experience with Medicare/Medicaid dual-eligible populations.
• Ability to travel 25–50% with reliable transportation.

Responsibilities

• Conduct comprehensive in-home LTSS assessments to determine eligibility.
• Complete and submit waiver documentation per guidelines.
• Develop and implement person-centered care plans.
• Apply clinical judgment to identify risk factors and reduce barriers to care.
• Coordinate services across interdisciplinary teams and community resources.
• Review claims and records to evaluate needs and utilization.
• Monitor progress and reassess needs as conditions change.
• Present cases at ICT meetings and collaborate with stakeholders.
• Ensure compliance with Medicaid waiver and CMS regulations.
• Document all activities per regulatory standards.
• Educate members and caregivers about benefits and resources.

Skills

RN license

Nursing experience

Case management

Medicare/Medicaid experience

LTSS knowledge

In-home assessments

EMR proficiency

Travel readiness

Education

AS or BS in Nursing

BSN preferred

Tools

EMR systems

Care management platforms

Job description

CVS Health is seeking an LTSS RN Case Manager to assess, plan, coordinate, and monitor care for dual‑eligible Medicare and Medicaid members. The role includes in‑home visits, waiver coordination, and development of person-centered service plans.

Travel 25–50% across Wayne/Macomb counties, with a 40-hour work week and standard business hours. Qualified candidates hold an active Michigan RN license, with 2+ years nursing and 1+ year case management experience.