Care Manager – Registered Nurse
Apply for the Care Manager – Registered Nurse role at CVS Health .
At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. We reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
Job Summary
The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.
Key Responsibilities
50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care.
Compile all available clinical information and partner with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs.
Provide evidence-based disease management education and support to help the member achieve health goals.
Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care.
Provide care coordination to support a seamless health care experience for the member.
Meticulous documentation of care management activity in the member’s electronic health record.
Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition.
Identify and connect members with health plan benefits and community resources.
Meet regulatory requirements within specified timelines.
Support other members of the Care Team through clinical decision making and guidance as needed.
Perform additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members, including special projects, process improvement initiatives, or mentoring new team members.
Essential Competencies & Functions
Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role.
Conduct oneself with integrity, professionalism, and self-direction.
Experience or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care.
Familiarity with community resources and services.
Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.
Maintain strong collaborative and professional relationships with members and colleagues.
Communicate effectively, both verbally and in writing.
Excellent customer service and engagement skills.
Required Qualifications
Active and unrestricted Registered Nurse (RN) licensure in the state of Georgia (GA) or Compact Registered Nurse (RN) license in state of residence.
Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams.
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position.
Confidence working at home and independence in using virtual collaboration tools.
3+ years of nursing experience.
2+ years of case management, discharge planning, and/or home healthcare coordination experience.
Preferred Qualifications
Experience providing care management for Medicare and/or Medicaid members.
Experience working with individuals with SDoH needs, chronic medical conditions, or behavioral health.
Experience conducting health-related assessments and facilitating the care planning process.
Bilingual skills, especially English-Spanish.
Education
Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED).
Bachelor’s of Science in Nursing (BSN) (PREFERRED).
License
Active and unrestricted Registered Nurse (RN) licensure in the state of Georgia (GA) or Compact Registered Nurse (RN) license in state of residence.
Compensation & Hours
Anticipated Weekly Hours: 40
Time Type: Full time
Pay Range: $54,095.00 – $116,760.00
Benefits
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all 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 access and many other benefits depending on eligibility.
We anticipate the application window for this opening will close on: 11/28/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.