Remote RN Case Manager — Telephonic Care Navigator

CVS Health; Nashville (TN); 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 to serve as a telephonic case manager for members across multiple states. The role emphasizes clinical judgment, coordination with care teams, and adherence to regulatory standards to optimize benefits and outcomes.

The position is fully remote with training conducted virtually in the United States. Eligible candidates hold a nursing degree and an active multi-state license, with oncology experience considered a plus.

Qualifications

• 5+ years' experience as a Registered Nurse, including at least 1 year in a hospital setting.
• Active multistate license via Nurse Licensure Compact (NLC) for compact states; non-compact states require state license for each state they support.
• 1+ years' experience documenting electronically using a keyboard.
• 1+ years' experience in Oncology.

Responsibilities

• Telephonic case management with patients and care teams for fully/self-insured clients.
• Apply applicable criteria, clinical guidelines, and policies to assess benefits and member needs.
• Use clinical judgment to address factors impacting care planning and resolution of issues.
• Conduct assessments using information from multiple sources to address conditions and comorbidities.
• Consult with supervisor and other teams to overcome barriers and meet goals.

Skills

Registered Nurse

Case management

Electronic documentation

Clinical judgment

Education

Diploma/ASN Nursing

Tools

Electronic health records

Job description

CVS Health is seeking an experienced Registered Nurse to serve as a telephonic case manager for members across multiple states. The role emphasizes clinical judgment, coordination with care teams, and adherence to regulatory standards to optimize benefits and outcomes.

The position is fully remote with training conducted virtually in the United States. Eligible candidates hold a nursing degree and an active multi-state license, with oncology experience considered a plus.