Registered Nurse Case Manager

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. A Brief Overview Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being. What you will do Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings. Analyzes complex patient data from medical history, diagnostic test results, and treatment plans, to understand the current health status of the patient. Applies in-depth knowledge of case management and nursing practices to organize patient files in an orderly manner for easy retrieval. Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans. Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care. Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient progress and manages specific conditions. Coordinates analytics projects to enable case managers to analyze data and generate reports on key performance health indicators. Designs complex processes to coordinate discharge planning in a safe and timely transition from the hospital to home. Develops resource management to help case managers optimize healthcare with community resources. Required Qualifications 5+ years of relevant work experience Active and unrestricted Registered Nurse Licensure in state of residence. Working knowledge of problem solving and decision making skills. Working knowledge of medical terminology. Working knowledge of digital literacy skills.Ability to deal tactfully with customers and community. Ability to handle sensitive information ethically and responsibly. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. 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. Education Associate's Degree in Nursing (REQUIRED) Bachelor's Degree (PREFERRED) 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: 09/04/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr