Care Manager Registered Nurse

CVS Health is hiring a Care Manager Registered Nurse to coordinate care for members with complex medical and social needs. In this role, you will perform telephonic and occasional in-person assessments, develop individualized care plans, and collaborate with physicians, pharmacies, and community resources to close gaps in care. You'll provide disease management education, support medication adherence, and help members navigate benefits and services. Using clinical guidelines and data, you'll identify risks, advocate for preventive care, and document all interventions accurately in care management systems while supporting CVS Health's inclusive, patient-first culture.

Responsibilities

• Conduct telephonic and/or in-person member assessments to identify clinical and social needs
• Develop and update individualized care plans based on evidence-based guidelines
• Coordinate care with physicians, pharmacists, and community providers to close gaps in care
• Educate members and caregivers on conditions, treatment plans, and preventive care
• Support medication adherence, reconciliation, and safe use of therapies
• Monitor member progress, adjust care plans, and escalate issues as needed
• Use care management software and EHR systems to document all activities accurately
• Identify high-risk members using data and clinical judgment for targeted interventions
• Collaborate with internal CVS Health teams to improve care quality and member experience
• Ensure compliance with regulatory, privacy, and clinical quality standards

Required Skills

• Care management
• Clinical assessment
• Chronic disease management
• Utilization management
• Care planning
• Electronic health records (EHR)
• Medication reconciliation
• Telehealth/telephonic nursing
• Interdisciplinary care coordination
• Health education and counseling