Remote RN Case Manager | Telephonic Care Navigator

CVS Health; Cheyenne (WY); Remote; USD 54,000 - 156,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement benefits

Wellness programs

Job summary

CVS Health is seeking an experienced telephonic RN Case Manager to support members nationwide from a remote home-based role. You will assess needs, apply guidelines, and coordinate care with care teams and providers.

Ideal candidates have 5+ years RN experience (1+ hospital), a multistate license, and oncology exposure, with strong documentation skills and URAC-aligned practice. This full-time role offers comprehensive benefits and ongoing training.

Qualifications

• 5+ years RN experience, including ≥1 year in a hospital setting.
• Active multistate license (NLC) for compact states.
• 1+ years' experience documenting electronically.
• 1+ years' Oncology experience.

Responsibilities

• Telephonic case management with patients and care team.
• Apply criteria and guidelines to assess benefits.
• Use clinical judgment to reduce risk factors and barriers.
• Assess co-morbid conditions impacting care planning.
• Discuss cases in case conferences for multidisciplinary focus.
• Collaborate with clinical teams to overcome barriers to goals.
• Follow case management processes and regulatory requirements.
• Use motivational interviewing to engage members.
• Identify and escalate member needs.
• Reach out to members to guide their care.
• Perform medical necessity reviews.

Skills

RN experience

Multistate license

Oncology experience

Electronic documentation

Case management

Bilingual Spanish

Education

Nursing diploma/ADN

Tools

NCCN Lexicomp

Job description

CVS Health is seeking an experienced telephonic RN Case Manager to support members nationwide from a remote home-based role. You will assess needs, apply guidelines, and coordinate care with care teams and providers.

Ideal candidates have 5+ years RN experience (1+ hospital), a multistate license, and oncology exposure, with strong documentation skills and URAC-aligned practice. This full-time role offers comprehensive benefits and ongoing training.