Case Manager Registered Nurse

CVS Health seeks a Field Case Manager Registered Nurse to coordinate care for members in home and community settings. You will assess clinical and psychosocial needs, develop person-centered care plans, and collaborate with providers, caregivers, and payers to improve outcomes and reduce avoidable hospitalizations. Responsibilities include patient education, medication and discharge review, closing care gaps, and documenting in electronic systems while meeting quality, utilization, and regulatory standards in a diverse, inclusive workplace.

Responsibilities

• Conduct in-home and community-based clinical and psychosocial assessments
• Develop and update individualized, person-centered care plans
• Coordinate services with physicians, hospitals, community resources, and caregivers
• Educate patients and families on conditions, medications, and self-management
• Review medications and discharges to reduce readmissions and close care gaps
• Document all activities in electronic health records accurately and timely
• Monitor outcomes and adjust interventions to meet quality and utilization goals
• Ensure compliance with regulatory, payer, and CVS Health policies
• Travel within assigned territory to visit members in field settings
• Collaborate with interdisciplinary teams to support complex cases

Required Skills

• Clinical assessment
• Case management
• Care planning
• Utilization management
• Electronic health records
• Patient education
• Interdisciplinary care coordination
• Regulatory compliance
• Medication reconciliation
• Data and outcomes tracking