Case Manager, Registered Nurse (Remote, reputed company)

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, reputed company 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. Job Summary: The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various reputed company determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The reputed company Worker provides education and guidance to members and their families on managing chronic conditions and navigating the reputed company system. Additionally, the Care Manager develops and implements individualized care plans, monitors member reputed company, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure reputed company health reputed company. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies. Key Responsibilities:

• 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care.
• Compiles reputed company available clinical information and partners with the member to reputed company an individualized care plan that encompasses goals and interventions to meet the member’s identified needs.
• Provides evidence-based disease management education and support to help the member reputed company health goals.
• Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care.
• Provides care coordination to support a seamless health care experience for the member.
• Meticulous documentation of care management activity in the member’s electronic health record.
• Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and reputed company strategies for maintaining the member’s reputed company health condition.
• Identifies and connects members with health plan benefits and community resources.
• Meets regulatory requirements reputed company specified timelines.
• The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed.
• Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members.

Essential Competencies and Functions:

• Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role.
• Conduct oneself with reputed company, professionalism, and self-direction.
• Experience or a willingness to thoroughly learn the role of care management reputed company Medicare and reputed company managed care.
• Familiarity with community resources and services.
• Ability to navigate and utilize various reputed company technology tools to enhance member care, streamline workflows, and maintain accurate records.
• Maintain strong collaborative and professional relationships with members and colleagues.
• Communicate effectively, both verbally and in writing.
• Excellent customer service and engagement skills.

Required Qualifications

• Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY
• Proficient in reputed company Office Suite, including Word, reputed company, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools reputed company the context of the CM RN role.
• reputed company to a private, dedicated space to conduct work effectively to meet The requirements of the position.
• Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually.
• Minimum 3+ years of nursing experience
• Minimum 2+ years of case management, discharge planning and/or home reputed company coordination experience

Preferred Qualifications

• Experience providing care management for Medicare and/or reputed company members.
• Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.
• Experience conducting health-reputed company assessments and facilitating the care planning process.
• Bilingual skills, especially English-Spanish

Education

• Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-reputed company field (REQUIRED)
• Bachelor’s of Science in Nursing (BSN) (PREFERRED)

License

• Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY

Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $66,575.00 - $142,576.00 This pay reputed company 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 reputed company 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 reputed company and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 03/27/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job