Remote RN Case Manager – Telephonic Care Coordination

CVS Health; Phoenix (AZ); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical, dental & vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a remote RN Case Manager to support members across multiple states. You will perform telephonic case management, applying clinical guidelines and pursuing collaborative care planning with patients, families, and care teams.

Responsibilities include coordinating benefits, addressing barriers, and conducting medical necessity reviews while adhering to URAC or internal standards. A strong background in oncology and EMR documentation is preferred.

Qualifications

• 5+ years of RN experience, including at least 1 year in a hospital setting.
• RN must have multi-state license via NLC to practice across participating states.
• 1+ year experience documenting electronically.
• 1+ year experience in Oncology.

Responsibilities

• Telephonic case management with patients and care teams for clients.
• Apply criteria and guidelines to assess benefits and member needs.
• Use clinical judgment to reduce risk factors and address barriers.
• Address all conditions including co-morbidities impacting care planning.
• Escalate cases to supervisors and participate in case conferences.

Skills

RN Case Manager experience

Oncology experience

Multistate license (NLC)

Electronic documentation

Bilingual Spanish (preferred)

Education

Diploma or Associate Degree in Nursing

Tools

Electronic Health Records (EHR)

EMR documentation tooling

Job description

CVS Health is seeking a remote RN Case Manager to support members across multiple states. You will perform telephonic case management, applying clinical guidelines and pursuing collaborative care planning with patients, families, and care teams.

Responsibilities include coordinating benefits, addressing barriers, and conducting medical necessity reviews while adhering to URAC or internal standards. A strong background in oncology and EMR documentation is preferred.