Remote RN Case Manager — Telephonic Care Coordination

CVS Health; Indianapolis (IN); 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 hiring an experienced RN Case Manager to work remotely from anywhere in the United States. You will support members across multiple states, coordinating benefits with care teams and applying evidence-based criteria to assess needs.

You will perform medical necessity reviews, exercise clinical judgment, and engage members using motivational interviewing to improve outcomes. A multistate license and hospital experience are essential, with oncology/transplant exposure preferred.

Qualifications

• 5+ years of RN experience with at least 1 year in hospital settings
• Active multistate license via NLC or state-specific RN license
• 1+ years documenting electronically
• Experience in Oncology/Transplant/Specialty areas

Responsibilities

• Work as telephonic case manager with patients and care teams
• Apply criteria, guidelines, policies to assess benefits and needs
• Use clinical judgment to design strategies to reduce risk factors
• Assess co-morbid conditions affecting care planning
• Consult with supervisors and cases at conferences for multidisciplinary focus
• Collaborate with colleagues to overcome barriers to goals
• Follow case management processes per policy and regulations
• Use motivational interviewing to engage members
• Identify and escalate member needs per guidelines
• Proactively reach out to members to guide their care
• Perform medical necessity reviews

Skills

Case management

Telephonic nursing

Multistate license

Clinical judgment

Education

Nursing diploma or ADN

Tools

Electronic health records

Job description

CVS Health is hiring an experienced RN Case Manager to work remotely from anywhere in the United States. You will support members across multiple states, coordinating benefits with care teams and applying evidence-based criteria to assess needs.

You will perform medical necessity reviews, exercise clinical judgment, and engage members using motivational interviewing to improve outcomes. A multistate license and hospital experience are essential, with oncology/transplant exposure preferred.