Remote RN Case Manager — Telephonic Care Navigator

CVS Health Corporation; Montpelier (VT); 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 an experienced Registered Nurse Case Manager for a remote, work-from-home role with virtual training. This position supports members across multiple states and uses clinical guidelines to manage care and utilization.

Your responsibilities include telephonic case management, applying criteria, and collaborating with care teams to ensure appropriate benefits and outcomes. Multi-state licensure is required, with oncology experience preferred.

Qualifications

• Active RN license in a compact state via NLC or individual state licenses
• Minimum 5 years RN experience, including hospital setting
• Experience documenting electronically with keyboard
• Experience in Oncology preferred or prior exposure

Responsibilities

• Telephonic case management with patients and care teams across multiple clients
• Apply clinical criteria, guidelines, and regulatory standards to assess benefits and needs
• Use clinical judgment to reduce risk factors and support care planning
• Assess multiple conditions and co-morbidities impacting functionality
• Escalate cases and collaborate with supervisors and Medical Directors
• Engage members to guide their care and perform medical necessity reviews

Skills

Registered Nurse

Multi-state license

Oncology experience

Telephonic case management

Electronic documentation

Education

Diploma or Associates Degree in Nursing

Tools

MCG

NCCN

Lexicomp

Job description

CVS Health is seeking an experienced Registered Nurse Case Manager for a remote, work-from-home role with virtual training. This position supports members across multiple states and uses clinical guidelines to manage care and utilization.

Your responsibilities include telephonic case management, applying criteria, and collaborating with care teams to ensure appropriate benefits and outcomes. Multi-state licensure is required, with oncology experience preferred.