Job Description

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.

Position Summary

Plan Sponsor business hours : Monday through Friday 7:00am to 6:00pm CST. There are currently no nights, no weekends, and no holidays; however, it is subject to change based on business needs. Your schedule must be 8 hours within this time frame and can include either a 30 or 60 min unpaid lunch.

The RN Case Manager plays a vital role in supporting members through telephonic assessment, care coordination, and strategic planning. This position focuses on evaluating each member’s medical needs and helping facilitate their overall wellness through a comprehensive, person‑centered approach.

Key Responsibilities

  • Conduct telephonic assessments and develop proactive, individualized care plans to improve both short‑ and long‑term health outcomes.
  • Use clinical tools, data insights, and benefit plan knowledge to evaluate member needs and ensure smooth integration across programs and services.
  • Apply clinical judgment to identify and address risk factors, barriers to care, and complex medical or social issues that influence health outcomes.
  • Complete holistic assessments that consider co‑morbid conditions, multiple diagnoses, functional limitations, and prior claims that may impact current care planning.
  • Evaluate each member’s level of work capacity, including any restrictions or limitations.
  • Determine the need for referrals to internal or external clinical resources using a whole‑person approach.
  • Collaborate with supervisors and multidisciplinary teams to overcome barriers, discuss challenging cases, and promote high‑quality care coordination.
  • Adhere to case management processes and maintain compliance with all regulatory and organizational policies and procedures.
  • Utilize strong interviewing and engagement skills to build rapport, understand health needs, and support members in navigating their care.

    • Required Qualifications

    Must have an active, current and unrestricted RN licensure in the state of residence and be willing to apply for a Compact RN (fees pd by company)

    5 years clinical practice experience as an RN

    Must be able to work Monday through Friday between the hours of 7:00am to 6:00 pm CST. There are currently no nights, no weekends, and no holidays; however, it is subject to change based on business needs.

    Preferred Qualifications

    6+ months Case Management or Utilization Management experience

    Case Management Certification
     

    Education

    Associate Degree 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. 
     

    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 all 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 

    We anticipate the application window for this opening will close on: 01/30/2026

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

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