Registered Nurse (RN) Care Coordinator Quality Medical Management

CVS Health · Pennsylvania, PA, United States

FULL TIME

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. This RN Case Manager position is 100% remote and candidates can apply from any state but must work the stated hours.

There is a preference for nurses in a compact RN licensure state, however, that is not required.

Normal Working Hours: Monday through Friday between the hours of 8:30am – 5:00pm in their time zone for a scheduled 8-hour shift.

Weekends and holidays may be required per the needs of the department. Currently, both weekends and holidays are on-call only and covered on a volunteer basis.

Less than 5% travel may be required for on-site meetings, trainings, or system updates, or to meet licensure requirements e.g., The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate overall wellness.

RN Case Manager:

– Collaboratively develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.

– Through the use of clinical tools and information/data review (e.g., assessments, claims, etc.) Applies clinical judgment to reduce risk factors, address complex health issues and social indicators.

– Utilizes case management processes in compliance with regulatory and company policies and procedures.

– Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Must have an active current and unrestricted RN license in state of residence. If located within the Nurse Licensure Compact jurisdiction, the ability to use their compact license without restriction

3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning)
Ability to use a computer station with multiple screens, operate multiple programs simultaneously, and sit for extended periods of time
A private designated workspace free of distractions and high-speed internet

Compact RN licensure

- 1+ years of case management experience

Certified Case Manager (CCM) certification
Strong customer service skills including attention to customers, sensitivity to certain issues and proactive identification/resolution of issues.
Experience with all types of Microsoft Office including PowerPoint, Excel, and Word
1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone.

Associates Degree in Nursing required.

- Bachelor's Degree in Science & Nursing preferred.

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 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.). 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.

Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications

Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and

virtual meetings.

Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or

similar (Google Workspace).

VPN, EHR portal), lock a computer screen when

unattended, manage strong passwords, and recognize suspicious emails or links.

Ability to resolve common technical issues independently, such as: restarting an application when

Full time Pay Range

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. 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 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.

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: 11/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Company	CVS Health
Location	Pennsylvania, PA, United States
Type	FULL TIME
Niche	healthcare