Remote RN Case Manager - Telephonic Care Coordination

CVS Health; Bismarck (ND); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a remote RN Case Manager to support members and care teams across the US. This telephonic role emphasizes clinical guidelines, evidence-based care plans, and proactive member engagement.

Ideal candidates have 5+ years of nursing experience, an active multistate license, oncology exposure, and electronic documentation experience. Full-time position with comprehensive benefits and ongoing virtual training.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• Must hold active multistate license or state-specific RN license for each state supported.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Perform telephonic case management for fully and/or self-insured clients.
• Apply criteria, guidelines and care plans to assess benefits and member needs.
• Use clinical judgment to reduce risk factors and address complex indicators.
• Assess information from multiple sources to address comorbid conditions.
• Collaborate with supervisors, Medical Directors and teams to meet goals.
• Utilize case management processes per regulatory and company policies.
• Engage members using motivational interviewing to assess health needs.
• Escalate member needs following established guidelines.
• Proactively reach out to members to guide their care.
• Conduct medical necessity reviews.

Skills

Case management

Telephonic nursing

Multistate licensure (NLC)

Education

Diploma or Associates Degree in Nursing

BSN Preferred

Job description

CVS Health is seeking a remote RN Case Manager to support members and care teams across the US. This telephonic role emphasizes clinical guidelines, evidence-based care plans, and proactive member engagement.

Ideal candidates have 5+ years of nursing experience, an active multistate license, oncology exposure, and electronic documentation experience. Full-time position with comprehensive benefits and ongoing virtual training.