RN Case Manager — Onsite Hospital Care Coordination

CVS Health Corporation; Pearland (TX); On-site; USD 61,000 - 130,000; Full time

Job summary

CVS Health Corporation is seeking a Hospital-based Case Manager RN to support Houston Methodist Hospital. The role requires an active Texas RN license and at least 3 years of clinical experience, with a focus on care coordination for Medicare and Commercial populations.

The position is on-site with travel between hospital units, emphasizes critical thinking, collaboration with care teams, and regulatory compliance. Bachelor’s degree preferred; strong MS Office skills are required.

Qualifications

• Active and unrestricted RN license in Texas.
• 3+ years of clinical experience, preferably with Medicare and Commercial populations.
• Ability to work independently within a hospital-based environment.
• Strong analytical, problem-solving, organizational, and communication skills.
• Proficiency in MS Word, Excel, Outlook, PowerPoint, and proprietary clinical systems.
• Efficient computer skills, including navigating multiple systems and keyboarding.
• Reliable transportation and the ability to consistently meet onsite, hospital-based-work requirements at Houston Methodist Hospital up to 50-75%.

Responsibilities

• Serve as liaison between members/clients, families, employers, providers, and insurance carriers.
• Implement and coordinate case management activities for catastrophic and chronically ill members across the continuum of care.
• Interact with members both telephonically and in person on-site at Houston Methodist Hospital.
• Assess medical, functional, and vocational status to develop and implement individualized plans of care.
• Communicate effectively with stakeholders including medical providers, attorneys, employers, and insurance carriers.
• Prepare timely and accurate documentation of all case management activities.
• Collaborate with internal multidisciplinary teams to support optimal member outcomes.
• Conduct outreach to treating physicians and specialists to support appropriate care planning.
• Provide education and preventive guidance to promote best clinical outcomes.
• Apply applicable laws, regulations, and payer requirements related to rehabilitation and case management services.
• Monitor member progress toward desired outcomes and adjust care plans as needed.
• Develop proactive strategies to address complex needs and support both short- and long-term wellness outcomes.

Skills

RN license TX

Clinical experience

Independent work

MS Office proficiency

Education

Associate's Degree in Nursing

Bachelor's Degree (preferred)

Tools

MS Office 365

Job description

CVS Health Corporation is seeking a Hospital-based Case Manager RN to support Houston Methodist Hospital. The role requires an active Texas RN license and at least 3 years of clinical experience, with a focus on care coordination for Medicare and Commercial populations.

The position is on-site with travel between hospital units, emphasizes critical thinking, collaboration with care teams, and regulatory compliance. Bachelor’s degree preferred; strong MS Office skills are required.