Case Manager Registered Nurse

CVS Health

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About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Plan Sponsor business hours : Monday through Friday 7:00am to 6:00pm CST. There are currently no nights, no weekends, and no holidays; however, it is subject to change based on business needs. Your schedule must be 8 hours within this time frame and can include either a 30 or 60 min unpaid lunch. The RN Case Manager plays a vital role in supporting members through telephonic assessment, care coordination, and strategic planning. This position focuses on evaluating each member’s medical needs and helping facilitate their overall wellness through a comprehensive, person‑centered approach.

Requirements

• Must have an active, current and unrestricted RN licensure in the state of residence and be willing to apply for a Compact RN (fees pd by company)
• 5 years clinical practice experience as an RN
• Must be able to work Monday through Friday between the hours of 7:00am to 6:00 pm CST. There are currently no nights, no weekends, and no holidays; however, it is subject to change based on business needs.

Nice To Haves

• 6+ months Case Management or Utilization Management experience
• Case Management Certification

Responsibilities

• Conduct telephonic assessments and develop proactive, individualized care plans to improve both short‑ and long‑term health outcomes.
• Use clinical tools, data insights, and benefit plan knowledge to evaluate member needs and ensure smooth integration across programs and services.
• Apply clinical judgment to identify and address risk factors, barriers to care, and complex medical or social issues that influence health outcomes.
• Complete holistic assessments that consider co‑morbid conditions, multiple diagnoses, functional limitations, and prior claims that may impact current care planning.
• Evaluate each member’s level of work capacity, including any restrictions or limitations.
• Determine the need for referrals to internal or external clinical resources using a whole‑person approach.
• Collaborate with supervisors and multidisciplinary teams to overcome barriers, discuss challenging cases, and promote high‑quality care coordination.
• Adhere to case management processes and maintain compliance with all regulatory and organizational policies and procedures.
• Utilize strong interviewing and engagement skills to build rapport, understand health needs, and support members in navigating their care.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree