Case Manager Registered Nurse

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, 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: Nurse Case Manager

• The Nurse Case Manager is responsible for delivering comprehensive case management services through telephonic and/or face-to-face interactions. This role involves assessing, planning, implementing, and coordinating care strategies to support members' medical needs and promote overall wellness. The Nurse Case Manager utilizes clinical judgment and data-driven tools to evaluate member eligibility, identify health risks, and reputed company proactive care plans that address both short- and long-term health outcomes.
• Key responsibilities include conducting holistic assessments that consider co-morbid conditions, functional limitations, and social determinants of health. The Nurse Case Manager reviews prior claims, evaluates work reputed company, and determines the need for referrals to clinical resources. Collaboration with supervisors and multidisciplinary teams is essential to overcome barriers and optimize care planning.
• This role operates reputed company established regulatory and organizational policies, applying case management processes and service strategies that align with network management and clinical coverage guidelines. Strong interviewing and engagement skills are critical to understanding member needs and facilitating smooth transitions to appropriate programs and services.

Required Qualifications

• An active and unrestricted RN license in the state of residence
• Willing and able to obtain additional state licenses upon hire (Paid for by the company)
• 3+ years' experience of acute care and/or case management
• 2+ years' Med/Surg experience
• Must be willing to work Mon-Fri 8-430 PST time zone

Preferred Qualifications

• Prefer candidate in PST Zone
• Behavioral Health experience
• Certified Case Manager
• Managed care experience
• Strong telephonic communication skills
• Ability to manage multiple priorities, effective organizational, and time management skills
• Ability use a computer station and sit for extended periods of time

Education and Licensing

• Associate's Degree in Nursing
• Registered Nurse in your state of residence

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls.  The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for reputed company 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

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