- R0882715
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate 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
Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.
Position Summary/Mission
Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.
Fundamental Components & Physical Requirements
- Acts as a liaison with member, family, provider(s), insurance companies, and healthcare personnel as appropriate.
- Implements and coordinates all 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 levels of care.
- Interacts with members/clients telephonically.
- Assesses and analyzes injured, acute, or chronically ill members medical; develops a plan of care to facilitate the member appropriate condition management to optimize wellness and medical outcomes, or optimal functioning.
Required Qualifications
- Candidate must have active and unrestricted Compact Registered Nurse (RN) License in their state of residence
- 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
Preferred Qualifications
- 2+ years case management, discharge planning and/or home health care coordination experience
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills
- Ability to work independently (may require working from home)
- Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
- Efficient and effective computer skills including navigating multiple systems and keyboarding
- Willing and able to obtain single state Registered Nurse (RN) licensure if needed
- Bilingual
- Certified Case Manager
- National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
Education
- Associate’s Degree or Nursing Diploma (REQUIRED)
- Bachelor’s Degree (PREFERRED)
Licensure
- Active and unrestricted Compact Registered Nurse (RN) License in their state of residence
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$66,575.00 – $142,576.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 05/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
