Remote RN Case Manager — Telephonic Care Coordination

CVS Health Corporation; Madison (WI); 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 work from home anywhere in the U.S., supporting fully and self-insured clients with telephonic case management. The role emphasizes clinical judgment, motivational interviewing, and adherence to UNC/URAC-aligned standards, with extensive nursing responsibilities in a national landscape.

The ideal candidate has 5+ years of RN experience (including hospital) and oncology exposure, plus active multistate licensure or state licenses.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• RN must hold an active multistate license through the Nurse Licensure Compact (NLC) or individual state licenses for non-compact states.
• 1+ years' experience documenting electronically.
• 1+ years' experience in Oncology.

Responsibilities

• Telephonic case management for patients and care teams for fully and/or self-insured clients.
• Apply criteria, clinical guidelines, and care management plans to assess benefits and member needs.
• Use clinical judgment to reduce risk factors and address barriers in care planning.
• Assess information from multiple sources to address comorbid conditions.
• Escalate issues and participate in case conferences for multidisciplinary input.
• Follow regulatory standards and company policies in case management processes.
• Use motivational interviewing to maximize member engagement and health status assessment.
• Identify and escalate member needs according to guidelines.
• Perform medical necessity reviews.

Skills

Telephonic case management

Clinical judgment

Motivational interviewing

Multistate license (NLC)

RN license (Active)

Education

Diploma or Associate Degree in Nursing

Job description

CVS Health is seeking a remote RN Case Manager to work from home anywhere in the U.S., supporting fully and self-insured clients with telephonic case management. The role emphasizes clinical judgment, motivational interviewing, and adherence to UNC/URAC-aligned standards, with extensive nursing responsibilities in a national landscape.

The ideal candidate has 5+ years of RN experience (including hospital) and oncology exposure, plus active multistate licensure or state licenses.