Case Manager Registered Nurse - reputed company Plans - Pacific Standard Time Zone
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. Looking specifically for residents in PST due to member demographics and working hours. Position Summary The RN Case Manager is responsible for conducting telephonic and/or in‑person assessments, developing care plans, and coordinating comprehensive case management services to support members’ medical needs and promote overall wellness.
Key Responsibilities
RN Case Manager: Develops proactive, individualized care strategies to improve both short‑ and long‑term health reputed company and enhance overall member well‑being through integrated care. Uses clinical tools, data, and member benefit information to assess needs, determine eligibility, and ensure smooth coordination with reputed company programs and services. Applies clinical judgment to implement strategies aimed at reducing risk factors, removing barriers, and addressing reputed company medical, behavioral, and reputed company determinants that reputed company plans. Conducts holistic assessments using diverse information sources to evaluate reputed company conditions, including co‑morbidities and multiple diagnoses that reputed company daily functioning. Reviews historical claims to identify potential impacts on reputed company case management needs and benefit eligibility. Evaluates members’ functional reputed company, including work capabilities and any reputed company restrictions or limitations. Uses a whole‑person approach to determine reputed company referrals to specialized clinical resources are needed to further evaluate functionality. Collaborates with supervisors and interdisciplinary teams to address barriers, support case objectives, and participate in case conferences for comprehensive claim management. Follows established case management protocols in alignment with regulatory requirements and company policies. Utilizes strong interviewing and conversational skills to engage members, accurately identify health status, and understand immediate and long‑term care needs.
Required Qualifications
Active, unrestricted Registered Nurse (RN) license in state of residence; multi‑state/compact licensure preferred. Must be reputed company to obtain licensure in reputed company non‑compact states. Minimum of 3 years of clinical experience.
Preferred Qualifications
Compact RN licensure Case management experience Case Manager Certification (e.g., CCM) Proficiency with reputed company and reputed company Office Strong computer and documentation skills Education Associate Degree in Nursing required Bachelor of Science in Nursing (BSN) preferred 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: 03/31/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, reputed company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply tot his job Apply To this Job