Case Manager Registered Nurse

CVS Health•Work At Home-Texas, TX

7d•$60,522 - $129,615•Remote

About The Position

Aetna National Medical Excellence (NME) is seeking an experienced Registered Nurse Case Manager for a blended Case Management and Utilization Management role supporting members with complex healthcare needs. This is a fully remote opportunity open nationwide, with preference for nurses residing in compact licensure states. The role partners with members, providers, and interdisciplinary teams to develop personalized care plans, improve health outcomes, reduce barriers to care, and promote wellness. The position is full time, with a Monday–Friday schedule of 8:00 AM–5:00 PM in the employee’s local time zone. Weekend and holiday work is based on business needs; the posting also states that no nights, weekends, or holidays are currently required. The company sponsors multi-state licensure and provides work equipment. Employees must meet the stated hardwired internet and secure home-workspace requirements, work from their confirmed home city and state, and provide their own desk or standing desk. The typical pay range is $60,522–$129,615. The position may also be eligible for a CVS Health bonus, commission, or short-term incentive program. Eligible benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources.

Requirements

Active, unrestricted Compact RN license in the state of residence.
At least 5 years of RN clinical practice experience.
At least 2 years of critical care experience.
At least 6 months of Case Management or Utilization Management experience.
Ability to work Monday through Friday, 8:00 AM–5:00 PM in the local time zone; weekends and holidays are based on business needs.
Willingness to obtain additional state RN licenses; the company pays for them.
Associate Degree in Nursing required.
Must have or be able to obtain a direct, hardwired internet connection to a modem/router within 7 feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted.
Must maintain a quiet, secure, private, organized designated home workspace that complies with CVS Health and HIPAA guidelines and allows uninterrupted work.
Must work within the state and city where the employee has confirmed they currently live.
Must provide workspace furniture, such as a desk or standing desk, and comply with the Work From Home requirements.
Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously.
Able to communicate using digital channels, including email, calendar invites, Teams messaging, and virtual meetings.
Experience with Microsoft Office 365 applications or similar tools such as Google Workspace.
Able to access secure systems such as VPN and EHR portals, follow computer and password security practices, and recognize suspicious emails or links.
Able to troubleshoot common technical issues independently and contact IT for unresolved issues.
Open to learning new skills as the workplace environment evolves.

Nice To Haves

Case Management Certification (CCM or equivalent).
Transplant nursing experience.
BSN preferred.

Responsibilities

Assess, coordinate, and manage care for members with complex medical needs.
Develop proactive care plans to improve short- and long-term health outcomes.
Identify clinical, social, and functional barriers affecting care.
Collaborate with healthcare providers and multidisciplinary teams.
Use clinical judgment to support utilization and care management decisions.
Engage members through telephonic care management and health coaching.

Benefits

Medical coverage.
Dental coverage.
Vision coverage.
Paid time off.
Retirement savings options.
Wellness programs.
Other resources, based on eligibility.
Company-sponsored multi-state licensure.
Company-provided work equipment, including a keyboard, monitor, computer, and headset.
Potential eligibility for a CVS Health bonus, commission, or short-term incentive program.