Remote RN Case Manager - Telephonic Care Navigator

CVS Health; Lincoln (NE); Remote; USD 54,000 - 156,000; Full time

Job summary

CVS Health is seeking an experienced RN Case Manager to operate remotely from anywhere in the United States. You will engage with patients and care teams by phone, applying clinical guidelines to determine benefits, and coordinating care across multiple states and programs.

The role emphasizes oncology exposure, meticulous documentation, and collaboration with clinical directors to ensure safe, cost-effective care for members under URAC-aligned standards.

Qualifications

• 5+ years of RN experience, including hospital setting exposure.
• Must hold active multistate license via NLC for compact states or state-specific licenses for non-compact states.
• Experience documenting electronically using keyboards for patient records.

Responsibilities

• Perform telephonic case management with patients and care teams.
• Assess benefits and member needs, applying criteria and guidelines.
• Use clinical judgment to reduce risk factors and address barriers in care plans.
• Conduct medical necessity reviews and coordinate with clinicians and programs.

Skills

Registered Nurse

Case Management

Oncology

Education

Diploma or Associates Degree in Nursing

Tools

Electronic Health Records

Job description

CVS Health is seeking an experienced RN Case Manager to operate remotely from anywhere in the United States. You will engage with patients and care teams by phone, applying clinical guidelines to determine benefits, and coordinating care across multiple states and programs.

The role emphasizes oncology exposure, meticulous documentation, and collaboration with clinical directors to ensure safe, cost-effective care for members under URAC-aligned standards.