Case Manager Registered Nurse

Remote RN Case Manager (Case Management & Utilization Management)

Aetna National Medical Excellence (NME) is seeking an experienced Registered Nurse (RN) Case Manager to join our growing team. This is a fully remote opportunity open to candidates nationwide, with preference given to nurses residing in compact licensure states.

In this blended role, you will combine Case Management and Utilization Management expertise to support members with complex healthcare needs. You'll partner with members, providers, and interdisciplinary teams to develop personalized care plans, improve health outcomes, reduce barriers to care, and promote overall wellness.

What You'll Do

• 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 impacting care
• Collaborate with healthcare providers and multidisciplinary teams
• Utilize clinical judgment to support effective utilization and care management decisions
• Engage members through telephonic care management and health coaching

Required Qualifications

• Active, unrestricted Compact RN license in state of residence
• 5+ years of RN clinical practice experience
• 2+ years of critical care experience
• 6+ months of Case Management or Utilization Management experience
• Ability to work Monday-Friday, 8:00 AM-5:00 PM in your local time zone. Weekends and Holidays are based on business needs.
• Willingness to obtain additional state RN licenses (company-paid)

Preferred Qualifications

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

Education

• Associate Degree in Nursing required
• BSN preferred

Why Join Us?

• 100% remote work environment
• No nights, weekends, or holidays currently required
• Company-sponsored multi-state licensure
• Opportunity to impact members' lives through innovative, integrated care management

If you're a clinically strong RN with critical care experience and a passion for improving patient outcomes, we'd love to hear from you. Apply today!

Work from Home Requirements:

• 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.
• The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
• If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements:

• 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.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 11/07/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.