[Hiring] Registered Nurse Case Manager @CVS Health

Role Description

Nurse Case Manager (RN) for a work-from-home role that requires frequent local travel for in-home member visits and occasional visits to nursing facilities within the Dallas & Surrounding Areas in Texas. In this role, you will deliver high-quality case management services through a combination of telephonic and face-to-face engagement, helping members navigate their healthcare needs and achieve improved health outcomes.

• Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs
• Develop and implement individualized care plans, ensuring alignment with clinical and program guidelines
• Coordinate and monitor ongoing care plan activities, adjusting as needed to improve outcomes
• Collaborate in multidisciplinary care reviews to optimize member health results
• Identify and escalate quality of care concerns through appropriate channels
• Engage members using motivational interviewing and coaching techniques to encourage healthy lifestyle choices
• Educate and empower members to actively participate in healthcare decision-making with their providers
• Use strong negotiation and coordination skills to secure appropriate services and resources
• Ensure accurate and timely documentation, adhering to regulatory, accreditation, and company standards
• Serve as a preceptor and mentor to new nurses and clinical staff
• Support onboarding by teaching policies, workflows, and best practices
• Foster a positive, supportive learning environment that promotes clinical excellence

Qualifications

• Active, unrestricted Registered Nurse (RN) license
• Bachelor’s degree in Nursing (BSN)
• Minimum 3+ years of clinical experience
• At least 1+ years of case management experience

Requirements

• Experience in a Managed Care Organization (MCO)
• STAR Kids program experience
• Bilingual (English/Spanish) preferred

Benefits

• Flexible work-from-home environment with meaningful in-person patient interaction
• Opportunity to make a real impact on member health outcomes and quality of life
• Collaborative team culture focused on growth, mentorship, and clinical excellence
• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources