Care Manager – Registered Nurse

$60,521.99 - $129,615 / year

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 Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, 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.
Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs.
Provides 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.
Provides 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.
Identifies and connects members with health plan benefits and community resources.
Meets regulatory requirements within specified timelines.
The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed.
Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members.

Essential Competencies and 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 a 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

Must have active and unrestricted Registered Nurse (RN) licensure in the state of CO OR compact licensure in state of residence
Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the CM RN role.
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position.
Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually.
Minimum 3+ years of nursing experience
Minimum 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, and/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

Must have active and unrestricted Registered Nurse (RN) licensure in the state of CO OR compact licensure in state of residence

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

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: 04/28/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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Recognizes the standard of care provided by the applicable professional organization and /or association. Quality Improvement: Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. Utilizes outcome data at the patient level to make care decisions. Participates in the quality improvement activities and uses quality measures to understand individual and unit performance. Safety: Minimize risk of harm to patients and providers through both system effectiveness and individual performance. Utilizes and discusses policy, procedures, and guidelines to support practice. Communicates observations or concerns related to unsafe situations that pose a risk to patients, families or the health care team. Informatics: Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making. Recognizes and applies information and technology of patient and unit outcomes to facilitate communication, clinical decision making, error prevention, and care coordination. Navigates and documents in the EMR to support patient care. Leadership: Nurses support organizational goals, advance the nursing profession, and enhance professional development by extending their influence to professional and community groups. Works within scope of practice and delegates according to Nurse Practice Act. Participates in professional governance activities. Seeks opportunities to participate in professional development activities Minimum Qualifications Degrees Bachelor of Science in Nursing (BSN) Area of Study Not applicable Experience One (1) year of nursing experience is required Equivalency Applicants with an Associate's Degree in Nursing and who agree to obtain a BSN within three (3) years from their start/hire date may be considered in lieu of a Bachelor of Science in Nursing (BSN) or Master’s Entry to Practice Nursing (MEPN) may substitute for a BSN. Licenses & Certifications BLS/CPR from the American Heart Association with at least six (6) months left before expiration is required upon hire. Current Colorado Registered Nurse (RN) license or RN license from multistate compact Additional Requirements BLS/CPR with at least six (6) months left before expiration. RN License from multistate compact. Competency None Salary Information Pay is dependent on applicant's relevant experience. Hourly Range: $38.34 to $57.51 Benefits Information Here, you matter. As a Children’s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career. As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April. Children’s Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year. EEO Statement It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained. Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.