Case Manager - Registered Nurse

$54,095 - $116,760 / 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.

Work Expectations

Access to a private, dedicated space to conduct work effectively to meet the requirements of the position
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted

Required Qualifications

Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in the 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 Care Manager – Registered Nurse (CM RN) role
Access to a private, dedicated space to conduct work effectively to meet the requirements of the position
Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted
Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually
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, 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

Active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $116,760.00

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: 05/20/2026

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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We want your knowledge and expertise! Job Summary and Qualifications As a Registered Nurse, you will be responsible for delivering high-quality, patient-centered care in line with the requirements of the department and the standards of practice for the relevant state and specialty. Collaborating with medical providers and the care team, you will provide personalized, comprehensive, and compassionate care, following established nursing models such as "Assess, Perform, Teach, and Manage." You will also act as an advocate for patients, families, and caregivers, embodying the organizations vision, mission, and values to ensure an outstanding patient experience and positive clinical outcomes. What you will do in this role: Assess the patients condition during admission and each scheduled shift, promptly identifying and reporting any changes in patient status. Perform procedures, monitoring, or other functions as ordered by the medical provider(s), and ensure thorough and timely documentation of care administration in the patients medical record. - Administer prescribed medications, monitor the patient for therapeutic response, and take appropriate action in the event of an unintended response to the medication. Provide exceptional care by responding promptly to patient requests, proactively anticipating patient needs, and resolving them. Educate patients, families, and caregivers about the patients medical condition, treatment plan, medications, possible side effects, and follow-up measures, ensuring complete understanding by translating complex medical terminology. What qualifications you will need: Registered Nurse Diploma Basic Cardiac Life Support (APRN) Advanced Practice Registered Nurse, or (RN) Registered Nurse Grand Strand Medical Center has provided quality healthcare services since 1978, giving patients access to highly-trained physicians and advanced technology. With more than 40 years of pioneering healthcare, our 300+ bed hospital is one of the regions leading acute care facilities. We offer a range of services for our patients - including the only cardiac surgery program, neurosurgery program, pediatric intensive care unit, Level I trauma center with two free-standing emergency departments, advanced wound care center, breast cancer center and Carolina Forest Imaging Center. We are recognized, for the chest pain, knee and hip replacement, sepsis and stroke by the Joint Commission. At Grand Strand Health, youll find that caring extends to our patients, our people and our South Carolina community. We are committed to each other because when we join together, our patients are cared for in the safest and most compassionate way. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "There is so much good to do in the world and so many different ways to do it." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Telemetry RN opening. Submit your application today and help advance the practice of nursing. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.