Role Description

This is a full-time, remote, telehealth role. Must live in a compact state and hold a compact license in MT or PST zones.

Working schedule is Monday-Friday, standard business hours in time zone of residence with one to two days per week until 7 PM MT or PST.

This is an exciting team to join because we specialize in engaging and advocating for disengaged, vulnerable members who often have multiple medical, behavioral, and social challenges. We’re uniquely positioned to meaningfully improve health outcomes and costs.

As Case Manager RN, you will be responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and facilitate the member’s overall wellness. You will develop a proactive course of action to address the issues presented to enhance their short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.

• Use clinical tools and information/data review to conduct an evaluation of members’ needs and benefits.
• Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conduct assessments that consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Use a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborate with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives.
• Utilize case management processes in compliance with regulatory and company policies and procedures.
• Utilize motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
• Work on behalf of the client and the member's provider.

Qualifications

• Registered Nurse that must reside in the Continental United States and hold an unrestricted nursing license with multi-state/compact privileges and have the ability to be licensed in all non-compact states.
• Must live in MT or PST zones.
• 3+ years clinical/nursing practice experience.
• 1+ year(s) of medical case management experience, care coordination or discharge planning.
• 3+ years of experience with personal computers, keyboarding, multi-systems navigation, and MS Office Suite applications.

Requirements

• High speed internet- ability to hard wire computer.
• 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 into 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.

Preferred Qualifications

• Telephonic case management experience.
• Excellent communication and interpersonal skills.

Education

• Associate's degree in nursing required.
• BSN 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.

Benefits

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.
• Other resources, based on eligibility.

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