Case Manager Registered Nurse - North Carolina in Moncure, NC

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 SummaryThe Case Manager RN role is available as a work‑from‑home position or a hybrid position. Hybrid work applies to candidates located within 30 miles of 4050 Piedmont Parkway, High Point, NC.Work ScheduleMonday–Friday, 9:00 AM–5:30 PM ESTOccasional evening, weekend, and holiday shifts based on team needs0–10% travel, which may include visits to the High Point office for customer meetingsRole OverviewThe RN Case Manager is responsible for conducting telephonic assessments and coordinating all aspects of case management. This includes planning, implementing, and evaluating care plans to support members’ medical needs and promote overall wellness.Key ResponsibilitiesDevelop proactive care plans to improve both short‑ and long‑term member outcomes and promote holistic wellness.Use clinical tools, data, and benefit plan knowledge to assess member needs and coordinate seamless transitions into Aetna programs and services.Apply clinical judgment to address barriers, risk factors, and complex medical or social issues that influence care planning.Conduct thorough assessments that incorporate multiple data sources and consider all relevant conditions, including co‑morbidities.Review historical claims to identify potential impacts on current case management or eligibility.Evaluate members’ work capacity and functional limitations.Identify when referral to additional clinical resources is needed using a holistic perspective.Collaborate with supervisors and multidisciplinary teams to overcome barriers and improve care outcomes; present cases in case conferences.Ensure compliance with regulatory requirements and company case management protocols.Use effective interviewing and engagement techniques to understand members’ health status and needs.Required QualificationsActive, unrestricted RN license in North CarolinaWillingness to obtain additional state RN licenses post‑hire (company‑funded)2+ years of clinical RN experience Experience from all clinical backgrounds is welcome, including:Emergency Department, Home Health, Hospice, OR, ICU, NICU, TelemetryMedical/Surgical, Orthopedics, Long‑Term Care, Infusion NursingPreferred QualificationsCertified Case Manager (CCM)3+ years of experience with Microsoft Office SuiteCase management experience in an integrated modelDischarge planning experienceManaged care experienceBSNEducationAssociate Degree in Nursing (ADN) required Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,095.00 - $116,760.00This 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 peopleWe 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 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.For more information, visit We anticipate the application window for this opening will close on: 02/25/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.