Case Manager RN - Work From Home - Boston, Massachusetts

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: This RN Case Manager position is 100% remote and candidates are required to live EST. Preference is for an RN with Compact RN licensure residing in Massachusetts. Normal Working Hours: Monday through Friday 8am-5pm in time zone of residence with requirement to flex time to meet member/business needs. 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..) conducts an evaluation of member’s needs and available benefits to collaborate and refer to programs offered by the plan sponsor. – 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. Please note: -This role involves using a computer station with multiple screens, operating multiple programs simultaneously, and sitting for extended periods of time. - A private designated workspace free of distractions and high-speed internet is needed for this position. Required Qualifications: -Must have an active and unrestricted RN license in state of residence, preferably compact -RN living in EST Time Zone -Willingness and ability to obtain additional state licenses upon hire (paid for by the company) -3+ years of acute care clinical experience as an RN (general medical, post-surgical, specialty including pediatrics, ICU, case management and discharge planning) -0-10% travel may be required Preferred Qualifications: -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 -Strong telephonic communication skills -1+ years of experience utilizing computers and navigating multiple monitors while speaking with someone on the telephone. -Transgender certification Education: -Associates in nursing -BSN Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $142,576.00 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 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: 08/01/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.