Case Manager RN

CVS Health•Work At Home-Pennsylvania, PA

1d•$60,522 - $129,615•Remote

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. Remote RN Case Manager 100% Remote | Nationwide Opportunity | Monday–Friday Schedule Are you a Registered Nurse passionate about helping members navigate complex healthcare needs? Join our Case Management team and make a meaningful impact by guiding members toward better health outcomes through personalized care planning, advocacy, and coordination.

Requirements

Active, unrestricted RN license in your state of residence
Ability to obtain multi-state/compact licensure (company-paid)
3+ years of clinical nursing experience
1+ year of experience using Microsoft Office (Outlook, Word, Excel)
Ability to work Monday–Friday with schedules starting as early as 8:00 AM in your local time zone
Ability to participate in rotating late shifts (up to 8:00 PM EST) and holiday on-call coverage as needed
You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
Future Growth: Openness to learning new skills in the future as the workplace environment evolves

Nice To Haves

Compact RN license
Case Management experience
Case Manager Certification (CCM or equivalent)
BSN preferred

Responsibilities

Conduct telephonic assessments to evaluate members' medical, behavioral, and social needs
Develop individualized care plans that support improved health outcomes and overall wellness
Identify barriers to care and implement strategies to reduce risk and improve member engagement
Coordinate care across providers, programs, and community resources
Review clinical information, claims history, and benefit eligibility to support appropriate interventions
Utilize motivational interviewing and clinical judgment to engage members and support goal achievement
Collaborate with multidisciplinary teams to address complex cases and facilitate optimal outcomes
Ensure compliance with regulatory requirements and company case management standards