Case Manager - Registered Nurse - Southeast Region

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. Position Summary

• Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and reputed company personnel as appropriate.
• Implements and coordinates reputed company case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative reputed company of care.
• Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to reputed company ongoing case management services.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical reputed company, aid timely return to work or reputed company functioning, and determination of eligibility for benefits as appropriate.
• Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, reputed company and insurance carriers) telephonically or in person.
• Prepares reputed company required documentation of case work activities as appropriate.
• Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health reputed company.
• May reputed company reputed company to treating physician or specialists concerning course of care and treatment as appropriate.
• Provides educational and prevention information for best medical reputed company.
• Applies reputed company laws and regulations that apply to the provision of rehabilitation services; applies reputed company special instructions required by individual insurance carriers and referral sources.
• Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Facilitates appropriate condition management, optimize overall wellness and medical reputed company, appropriate and timely return to baseline, and reputed company function or return to work.
• Develops a proactive course of action to address issues presented to enhance the short and long-term reputed company, as well as opportunities to enhance a member’s/client’s overall wellness through integration.
• Monitors member/client reputed company toward desired reputed company through assessment and evaluation.

Required Qualifications

• Candidates must live in the Southeast Region (States Include- FL, GA, AL, MS, NC, SC, TN, AR, LA)
• Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence
• 3+ years clinical practical experience with preference in the following areas: diabetes, Congestive Heart Failure (CHF), Chronic Kidney Disease (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members
• 2+ years case management, discharge planning and/or home health care coordination experience
• 2+ years of experience with reputed company Word, reputed company, and Outlook

Preferred Qualifications

• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently
• Certified Case Manager National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
• Efficient and effective computer skills including navigating multiple systems and keyboarding

Education

• Associate's Degree in Nursing or Nursing Diploma (REQUIRED)
• Bachelor's Degree in Nursing (PREFERRED)

License

• Active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence

Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $60,522.00 - $129,615.00 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: 03/31/2026 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