Telehealth Jobs | Credenza

Care Manager – Registered Nurse

$60,522.01 - $129,615 / year

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. 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 RNrole. 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 40 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.

Care Manager – Registered Nurse

CVS Health CO

$60,521.99 - $129,615 / year

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. 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 40 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.

Registered Nurse

Oak Street Health Fort Wayne, IN

$54,095 - $116,760 / year

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. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 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: 10/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

Telehealth Preventative Primary Care Advanced Practice Provider- NP/PA

Devoted Health Clackamas, OR

$115,000 - $140,000 / year

Job Description About the Role: As a Devoted Preventative Primary Care Provider, you’ll be part of a mission-driven, interdisciplinary clinical team focused on improving the health, dignity, and quality of life of our members. You’ll meet patients in the first step of their primary care journey with Devoted Medical. You’ll conduct comprehensive clinical assessments, support chronic condition management, and emphasize preventative and proactive care. You’ll collaborate closely with primary care providers, specialists, pharmacists, nurses, care coordinators, caregivers, and families to deliver coordinated, member-centered care. This role sits at the intersection of preventative care, primary care and complex care management — it is not a traditional primary care panel role, and it’s not a one-time Annual Wellness Visit role. You’ll develop a relationship with your members while working in a supportive, tech-enabled environment designed to optimize clinical time and connection. What You’ll Do: Conduct primarily telehealth video visits, with limited and occasional in-home visits to members in your local area. Perform comprehensive assessments and provide evidence-based care focused on prevention, chronic condition support, medication optimization, and health maintenance. Identify and address care gaps, coordinate with external and internal care team members, and contribute to individualized, whole-person care plans. Utilize integrated technology and AI-enabled workflows to reduce administrative burden and maximize meaningful member interaction time. Communicate with empathy and clarity, fostering trust and confidence with members and caregivers. Required Skills & Experience: Active Nurse Practitioner (APRN/NP) or Physician Assistant (PA) license. 3+ years of outpatient clinical practice, ideally in primary care, family medicine, internal medicine, or geriatrics. Active and clear NP/PA license in at least one of the following states: AL, AZ, AR, CO, FL, GA, HI, IL, IN, KY, MS, MO, NC, OH, PA, SC, TN, TX (must be willing to obtain additional licenses within the first 90 days — support and reimbursement provided) Active BLS certification at time of hire. Comfort with delivering care via video telehealth and using electronic documentation systems. Preferred Experience: Familiarity with managed care models, including STARS/HEDIS and identification of care gaps. Experience performing comprehensive or preventive care visits with Medicare populations. Experience supporting older adults and/or individuals with complex medical or social needs. You’ll Thrive in This Role If You… Find meaning in caring for older adults and supporting them in living healthier, more independent lives. Lead with empathy, humility, and curiosity. Value feedback, reflection, and personal and professional growth. Enjoy working within a collaborative, supportive, tech-enabled care team environment. Why You’ll Love Working Here: Member-first care: Time to build relationships — quality matters more than quantity. Mission with heart: Every visit is an opportunity to improve someone’s health and dignity. Flexible remote environment: Work from home while still being part of a tight-knit clinical community. Growth & stability: Opportunities to expand licensure, clinical skills, and career pathways. Schedule options: Standard schedules available; eligibility for 4x10 schedule after successful completion of first 90 days (post onboarding) and performance expectations. Salary range: $115,000 - $140,000 annually If you’re passionate about providing thoughtful, preventative care — and want to make a lasting impact on the lives of older adults — we’d love to meet you. The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission! Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Bilingual Telehealth Preventative Primary Care Advanced Practice Provider- NP/PA

Devoted Health Clackamas, OR

$115,000 - $140,000 / year

Job Description About the Role: As a Devoted Preventative Primary Care Provider, you’ll be part of a mission-driven, interdisciplinary clinical team focused on improving the health, dignity, and quality of life of our members. You’ll meet patients in the first step of their primary care journey with Devoted Medical. You’ll conduct comprehensive clinical assessments, support chronic condition management, and emphasize preventative and proactive care. You’ll collaborate closely with primary care providers, specialists, pharmacists, nurses, care coordinators, caregivers, and families to deliver coordinated, member-centered care. This role sits at the intersection of preventative care, primary care and complex care management — it is not a traditional primary care panel role, and it’s not a one-time Annual Wellness Visit role. You’ll develop a relationship with your members while working in a supportive, tech-enabled environment designed to optimize clinical time and connection. What You’ll Do: Conduct primarily telehealth video visits, with limited and occasional in-home visits to members in your local area. Perform comprehensive assessments and provide evidence-based care focused on prevention, chronic condition support, medication optimization, and health maintenance. Identify and address care gaps, coordinate with external and internal care team members, and contribute to individualized, whole-person care plans. Utilize integrated technology and AI-enabled workflows to reduce administrative burden and maximize meaningful member interaction time. Communicate with empathy and clarity, fostering trust and confidence with members and caregivers. Required Skills & Experience: Active Nurse Practitioner (APRN/NP) or Physician Assistant (PA) license. 3+ years of outpatient clinical practice, ideally in primary care, family medicine, internal medicine, or geriatrics. Active and clear NP/PA license in at least one of the following states: AL, AZ, AR, CO, FL, GA, HI, IL, IN, KY, MS, MO, NC, OH, PA, SC, TN, TX (must be willing to obtain additional licenses within the first 90 days — support and reimbursement provided) Active BLS certification at time of hire. Comfort with delivering care via video telehealth and using electronic documentation systems. Preferred Experience: Familiarity with managed care models, including STARS/HEDIS and identification of care gaps. Experience performing comprehensive or preventive care visits with Medicare populations. Experience supporting older adults and/or individuals with complex medical or social needs. You’ll Thrive in This Role If You… Find meaning in caring for older adults and supporting them in living healthier, more independent lives. Lead with empathy, humility, and curiosity. Value feedback, reflection, and personal and professional growth. Enjoy working within a collaborative, supportive, tech-enabled care team environment. Why You’ll Love Working Here: Member-first care: Time to build relationships — quality matters more than quantity. Mission with heart: Every visit is an opportunity to improve someone’s health and dignity. Flexible remote environment: Work from home while still being part of a tight-knit clinical community. Growth & stability: Opportunities to expand licensure, clinical skills, and career pathways. Schedule options: Standard schedules available; eligibility for 4x10 schedule after successful completion of first 90 days (post onboarding) and performance expectations. Salary range: $115,000 - $140,000 annually If you’re passionate about providing thoughtful, preventative care — and want to make a lasting impact on the lives of older adults — we’d love to meet you. The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium Generous paid time off $100 monthly mobile or internet stipend Stock options for all employees Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce. At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission! Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business. As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Weekend Clinical Triage Specialist RN, Connect to Care - Access Center

St. Luke's University Health Network Allentown, PA

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. A Clinical Triage Specialist (CTS) (RN) - Connect to Care - Access Center will compassionately deliver an exceptional patient experience and provide clinical support to CTS-MA team members by serving as a clinical resource. The CTS-RN is responsible for using nursing judgment in answering/returning patient calls related to direct care provided by the practices. When appropriate, the caller’s symptoms will be assessed and triaged using approved nursing protocols and guidelines in order to assist in obtaining the appropriate level of care and/or self-care advice. JOB DUTIES AND RESPONSIBILITIES: Answers telephones, prioritizes clinical triage calls, follows clinical protocols, and coordinates services, as needed. Verifies patient demographic information and accurately enters the updated information into electronic health record. Serves as an escalation point for clinical patient issues and other POD team members requiring clinical support and provides clinical advice based on clinical protocols and procedures. Manages and responds to escalated electronic patient messages whenever not answering inbound patient calls, and uses clinical judgment to prioritize and accommodate patients. Creates a positive patient experience at every encounter, attempting to independently resolve any issues or concerns of the patient at the time of the phone call, within the scope of the role. Consistently meets productivity, schedule adherence, and quality standards as set by the Access Center. Utilizes all resources and guidelines at his/her disposal to effectively assess, prioritize, advise, schedule appointments, or refer calls when necessary to the appropriate medical facility or personnel. Accurately documents symptoms/complaints, nursing assessment, advice provided and patient/caller response. Partners with other Access Center teams/PODs and respective practice clinical team on behalf of the patient to assist with clinical concerns, medication refills, or scheduling appointments. Other related duties as assigned. PHYSICAL AND SENSORY REQUIREMENTS: Requires sitting for extended periods of time (up to 8 hours at time). Requires continual use of fingers, writing and computer entry. Requires ability to hear normal conversation and good general near and peripheral vision. EDUCATION: Graduate of an accredited nursing program. Active Registered Nurse licensure in the state of Pennsylvania and New Jersey or other nursing compact state and other states as deemed necessary by state law. TRAINING AND EXPERIENCE: Minimum two years recent clinical experience in a physician office, home health, critical care and/or emergency room is required Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.

Case Manager Registered Nurse

CVS Health PA

$54,095 - $129,615 / year

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. Case Manager RN (100% Remote – Nationwide) Full‑Time | Work from Anywhere Nationwide | No Travel Required We’re seeking a compassionate and results‑driven Case Manager RN to support members through personalized, high‑quality care coordination. In this fully remote role, you’ll use clinical expertise, data‑driven insights, and strong advocacy to help members achieve optimal, cost‑effective health outcomes. What You’ll Do Conduct comprehensive clinical assessments and identify care coordination needs Develop, implement, and monitor individualized case management plans Support inpatient review and discharge planning as appropriate Advocate for members to maximize benefits and access appropriate services Engage members through coaching, education, and motivational interviewing Identify and escalate quality‑of‑care concerns Deliver exceptional customer experience while collaborating with care teams and Medical Directors Schedule Monday–Friday, 9:00 AM–5:30 PM (your local time zone) Occasional rotating late shift as needed ( 11:30 AM–8:00 PM EST ) Required Qualifications Active, unrestricted RN license in your state of residence Willingness to obtain additional state licenses (company paid) 3+ years of acute care RN experience (Med‑Surg or Critical Care preferred) Strong clinical judgment, decision‑making, and organizational skills Preferred Qualifications Compact or multi‑state RN license Certified Case Manager (CCM) Telephonic case management or telephonic clinical experience Education Associate Degree in Nursing (required) BSN (preferred) Why Join Us? 100% remote—live in any state No travel required Meaningful work improving member health and outcomes Supportive, collaborative team environment Apply today to bring your RN expertise to a flexible, impactful case management role. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $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: 05/02/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Case Manager Registered Nurse

CVS Health OH

$60,522 - $129,615 / year

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 This RN Case Manager role is 100% remote, and the employee can live in any state and telework, however, there is a preference for an RN in a Compact RN state. Normal hours are Monday through Friday 8:00am – 4:30pm in the time zone of residence with occasional late shift rotation until 8:00pm. Employees can flex their 8-hour shift between 8:00am-6:00pm. There are no weekends or holiday shifts required at this time. Travel of less than 5% may be required in the event of clinical audits. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. RN Case Manager: – Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. – Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. – Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. – Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. – Reviews prior claims to address potential impact on current case management and eligibility. – Assessments include the member’s level of work capacity and related restrictions/limitations. – Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. – Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. – Utilizes case management processes in compliance with regulatory and company policies and procedures. – Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Required Qualifications Must have an active current and unrestricted RN license in state of residence - Willingness and ability to obtain additional state licenses upon hire (paid for by the company) - 3+ years of acute hospital clinical experience as an RN (general medical, post-surgical, ICU experience). - Travel of less than 5% may be required in the event of clinical audits. - Normal hours are Monday through Friday 8:00am – 4:30pm in the time zone of residence with occasional late shift rotation until 8:00pm. Employees can flex their 8-hour shift between 8:00am-6:00pm. Preferred Qualifications - 1+ years of case management and/or Home Health experience - Compact RN licensure - Certified Case Manager (CCM) certification - Experience with all types of Microsoft Office including PowerPoint, Excel, and Word - Strong telephonic communication skills Education Associate’s degree in nursing required BSN preferred Anticipated Weekly Hours 40 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: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Case Manager Registered Nurse

CVS Health

$60,522 - $129,615 / year

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 This RN Case Manager role is 100% remote, and the employee can live in any state and telework, however, there is a preference for an RN in a Compact RN state. Normal hours are Monday through Friday 8:00am – 4:30pm in the time zone of residence with occasional late shift rotation until 9:00pm. Employees can flex their 8-hour shift between 8:00am-6:00pm. There are no weekends or holiday shifts required at this time. Travel of less than 5% may be required in the event of clinical audits. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. RN Case Manager: – Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. – Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. – Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. – Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. – Reviews prior claims to address potential impact on current case management and eligibility. – Assessments include the member’s level of work capacity and related restrictions/limitations. – Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. – Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. – Utilizes case management processes in compliance with regulatory and company policies and procedures. – Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Required Qualifications - Must have an active current and unrestricted RN license in state of residence - Willingness and ability to obtain additional state licenses upon hire (paid for by the company) - 3+ years of acute hospital clinical experience as an RN (general medical, post-surgical, ICU experience). - Travel of less than 5% may be required in the event of clinical audits. - Normal hours are Monday through Friday 8:00am – 4:30pm in the time zone of residence with occasional late shift rotation until 8:00pm. Employees can flex their 8-hour shift between 8:00am-6:00pm. Preferred Qualifications - 1+ years of case management and/or Home Health experience - Compact RN licensure - Certified Case Manager (CCM) certification - Experience with all types of Microsoft Office including PowerPoint, Excel, and Word - Strong telephonic communication skills Education Associate’s degree in nursing required BSN preferred Anticipated Weekly Hours 40 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: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

RN Case Manager (IKC)

DaVita Kidney Care Malvern, PA

$68,400 - $100,400 / year

Posting Date 04/17/2026 2476 Swedesford RdSte 150, Malvern, Pennsylvania, 19355-1456, United States of America Job Description This DaVita IKC Nurse position is a remote-based position. This position functions autonomously and in collaboration with all members of the healthcare team to coordinate and facilitate quality, cost-effective care while minimizing fragmentation of the healthcare delivery system for ESRD and CKD patients. This position provides coordination of care between the patient, family, physician, provider and care teams, the community, and Regional Operations Manager. NOTE: The DaVita IKC position can be telephonic based, field based, or a combination of both telephonic and field. Field based positions require home offices and travel to dialysis centers in designated geographic area. Telephonic positions that are remote will require home offices. DaVita Integrated Kidney Care (DaVita IKC) is an the integrated care division of DaVita Inc. working on DaVita’s vision to provide integrated care to all ESRD patients, who are some of the most medically complex and vulnerable patient populations in the US. Our more than 600 dedicated nurses, care coordinators, nurse practitioners (NPs) and business professionals integrate and manage care for more than 20,000 patients with late-stage chronic kidney disease (CKD) and end stage renal disease (ESRD) across the US each month. We’ve proven that integrating care achieves the triple aim of improved patient quality of life, better outcomes and lower total cost of care. What sets DaVita IKC apart is that we not only provide great care management but we start with our heart with our patients and each other. We focus on creating both a great experience for our patients and a special place to work for our teammates. We’re on a mission to revolutionize kidney care, with a vision of making integrated care the standard of care for all renal patients. To help us achieve our vision, we’re investing extensively in developing both our model of care and our team. When you join DaVita IKC, you're joining a compassionate team committed to quality patient care. Through our commitment to training, growth and quality we consistently achieve superior clinical outcomes while giving teammates the opportunity to excel in an award-winning environment that enables them to thrive both professionally and personally . Qualifications for the Shining Star for our DaVita IKC Registered Nurse are: A.D.N degree from accredited school of nursing required; B.S.N preferred; three-year diploma from accredited diploma program may be substituted for nursing degree Current Registered Nurse (RN) license in the state of practice required Continuing education credits maintained as required by state of practice required Minimum of five (5) years’ experience in clinical nursing required Minimum of three (3) years’ experience in renal nursing preferred Demonstrated knowledge and understanding of data and managing to clinical, financial, and patient satisfaction outcomes Demonstrated experience and effectiveness in change agent role Demonstrated knowledge and understanding of CQI techniques Previous experience in healthcare performance coaching required Certified Nephrology Nurse (CNN) or Certified Case Manager (CCM) preferred Current CPR certification required Ability to modify personal practice patterns to adapt to new / electronic processes and increased productivity expectations as it pertains to Capella implementation Current driver’s license in state employed with positive driving record and able to meet requirements of insurance coverage required Basic computer skills and proficiency in MS Word and Outlook required Functional proficiency with DaVita specific clinical software programs, including Capella, required within 90 days of employment Home office with internet connectivity at minimum of 1MB upload and 1MB download speed required Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen." Why wait? Explore a career with DaVita today. Go to http://careers.davita.com to learn more or apply. What We’ll Provide: More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings. Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning. #LI-EO1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. The Salary Range for the role is $68,400.00 - $100,400.00 per year. If a candidate is hired, they will be paid at least the minimum wage according to their geographical jurisdiction and the exemption status for the position. New York Exempt: New York City and Long Island: $66,300.00/year, Nassau, Suffolk, and Westchester counties: $66,300.00/year, Remainder of New York state: $62,353.20/year New York Non-exempt: New York City and Long Island: $17.00/hour, Nassau, Suffolk, and Westchester counties: $17.00/hour, Remainder of New York state: $16.00/hour Washington Exempt: $80,168.40/year Washington Non-exempt: Bellingham: $19.13/hour, Burien: $21.63/hour, Everette: $20.77/hour, Unincorporated King County: $20.82/hour, Renton: $21.57/hour, Seattle: $21.30/hour, Tukwila: $21.65/hour, Remainder of Washington state: $17.13/hour For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.

Case Manager Registered Nurse

CVS Health

$60,522 - $129,615 / year

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 This RN Case Manager role is 10 0% remote, and the employee can live in any state and telework, however, there is a preference for an RN in a Compact RN state. Normal hours are Monday through Friday 8:00am – 4:30pm in the time zone of residence with occasional late shift rotation until 8:00pm. Employees can flex their 8-hour shift between 8:00am-6:00pm. There are no weekends or holiday shifts required at this time. Travel of less than 5% may be required in the event of clinical audits. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. RN Case Manager: – Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. – Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. – Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. – Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. – Reviews prior claims to address potential impact on current case management and eligibility. – Assessments include the member’s level of work capacity and related restrictions/limitations. – Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. – Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. – Utilizes case management processes in compliance with regulatory and company policies and procedures. – Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Required Qualifications - Must have an active current and unrestricted RN license in state of residence - Willingness and ability to obtain additional state licenses upon hire (paid for by the company) - 3+ years of acute hospital clinical experience as an RN (general medical, post-surgical, ICU experience). - Travel of less than 5% may be required in the event of clinical audits. - Normal hours are Monday through Friday 8:00am – 4:30pm in the time zone of residence with occasional late shift rotation until 9:00pm. Employees can flex their 8-hour shift between 8:00am-6:00pm. Preferred Qualifications - 1+ years of case management and/or Home Health experience - Compact RN licensure - Certified Case Manager (CCM) certification - Experience with all types of Microsoft Office including PowerPoint, Excel, and Word - Strong telephonic communication skills Education Associate’s degree in nursing required BSN preferred Anticipated Weekly Hours 40 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: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Remote Registered Nurse Case Manager (NY RN License Required)

CVS Health New York, NY

$66,575 - $142,576 / year

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. 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 NY 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 NY 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: 04/22/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Case Manager Registered Nurse

CVS Health AZ

$60,522 - $129,615 / year

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: The Case Manager RN role is 100% remote work from home and candidates must have an active RN licensure (any state). Normal Working Hours: Monday through Friday 9:00am – 5:30pm in time zone of residence. Occasional evening, weekend, and holiday shifts per the needs of the team. No travel is expected with this position. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. RN Case Manager: – Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. – Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. – Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. – Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. – Reviews prior claims to address potential impact on current case management and eligibility. – Assessments include the member’s level of work capacity and related restrictions/limitations. – Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. – Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. – Utilizes case management processes in compliance with regulatory and company policies and procedures. – Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Required Qualifications -Must have an active RN licensure in the state where you reside. -Multiple State RN licensure is welcomed but not required. If chosen must be willing and able to obtain multiple state RN licensure after hire (expenses paid for by company) -2+ years of clinical experience as an RN -All clinical experience will be considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical / Surgical, Orthopedics, Long Term Care, and Infusion nursing. Preferred Qualifications -Certified Case Manager (CCM) certification -Prefer candidates who reside in compact states. -3+ years’ experience with Microsoft Office Suite -Case Management in an integrated model -Discharge Planning experience -Managed care experience -BSN preferred Education -Associates Degree in Nursing Anticipated Weekly Hours 40 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: 04/21/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Clinical Triage Specialist (RN) - GI/Colorectal (PA & NJ Residents Only)

St. Luke's University Health Network Allentown, PA

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Clinical Triage Specialist (CTS) (RN) - Access Center will compassionately deliver an exceptional patient experience and provide clinical support to CTS-MA team members by serving as a clinical resource. The CTS-RN is responsible for using nursing judgment in answering/returning patient calls related to direct care provided by the practices. When appropriate, the caller’s symptoms will be assessed and triaged using approved nursing protocols and guidelines to assist in obtaining the appropriate level of care and/or self-care advice. JOB DUTIES AND RESPONSIBILITIES: Answers telephones, prioritizes clinical triage calls, follows clinical protocols, and coordinates services, as needed. Verifies patient demographic information and accurately enters the updated information into electronic health record. Serves as an escalation point for clinical patient issues and other POD team members requiring clinical support, and provides clinical advice based on clinical protocols and procedures. Manages and responds to escalated electronic patient messages whenever not answering inbound patient calls and uses clinical judgment to prioritize and accommodate patients. Creates a positive patient experience at every encounter, attempting to independently resolve any issues or concerns of the patient at the time of the phone call, within the scope of the role. Consistently meets productivity, schedule adherence, and quality standards as set by the Access Center. Utilizes all resources and guidelines at his/her disposal to effectively assess, prioritize, advise, schedule appointments, or refer calls when necessary to the appropriate medical facility or personnel. Accurately documents symptoms/complaints, nursing assessment, advice provided and patient/caller response. Partners with other Access Center teams/PODs and respective practice clinical team on behalf of the patient to assist with clinical concerns, medication refills, or scheduling appointments. Other duties as assigned. EDUCATION: Graduate of an accredited nursing program. Active Registered Nurse licensure in the state of Pennsylvania and New Jersey or other nursing compact state and other states as deemed necessary by state law. TRAINING AND EXPERIENCE: Minimum 2 years recent clinical experience in a physician office, home health, critical care and/or emergency room is required. Strong communication skills Focused on compliance Demonstrates continuous growth Quality-driven Service-oriented Excels at time management Strong problem-solving skills Ability to work from home in accordance with the Network Work from Home Policy if needed. Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.

Case Manager - Registered Nurse

CVS Health NJ

$60,522 - $142,576 / year

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 Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Family Summary/Mission 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 and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes. Required Qualifications Candidate must have an active and unrestricted Compact Registered Nurse (RN) license in the state of residence 5+ years clinical practical experience preference: (diabetes, congestive heart failure (CHF), chronic kidney disease (CKD), post-acute care, hospice, palliative care, cardiac) with Medicare members 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 Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications Efficient and effective computer skills including navigating multiple systems and keyboarding Preferred Qualifications Candidate must be willing obtain additional state Registered Nurse (RN) licenses if needed, company will provide 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) License Active and unrestricted Compact Registered Nurse (RN) license in state of residence Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $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: 04/28/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Case Manager Registered Nurse (Remote, East Coast)

CVS Health CT

$66,575 - $142,576 / year

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. Schedule Monday - Friday 8:00 AM - 5:00 PM ET Program Overview Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Family Summary/Mission 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 and family’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/client /family, employer, 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 or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services. • Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. • Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person. • Prepares all required documentation of case work activities as appropriate. • Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes. • May make outreach to treating physician or specialists concerning course of care and treatment as appropriate. • Provides educational and prevention information for best medical outcomes. • Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. • Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. • Utilizes case management processes in compliance with regulatory and company policies and procedures. • Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work. • Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration. • Monitors member/client progress toward desired outcomes through assessment and evaluation. Required Qualifications • Active and unrestricted Registered Nurse License in East Coast States • Minimum 3+ years clinical practical experience with Medicare members (specifically diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac members) • Minimum 2+ years CM, discharge planning and/or home health care coordination experience • Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills. • Ability to work independently Preferred Qualifications • Bilingual • Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) • Compact RN license or willing and able to obtain multi-state RN licenses if needed Education • Associate's Degree Required, Bachelor's Preferred 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: 05/01/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Nurse Practitioner

Firefly Health Seattle, WA

$130,000 - $150,000 / year

Firefly Health is building a revolutionary new type of comprehensive health "care and coverage,” powered by a relationship-driven care team, a trusted virtual and in-person clinical network, and our proprietary technology platform. Founded by experienced clinicians and technology leaders, Firefly Health is on a mission to deliver clinical and financial health through joyful, always there care. We are flipping the script on what it means to be a health plan and actually providing a true health benefit to members. We are intensely focused on optimizing the physical + mental + financial wellbeing of those who want (and deserve) something better than the status quo. If you are ready to roll up your sleeves and take on our audacious mission, we would love to hear from you. The Role Nurse Practitioners are at the heart of the Firefly clinical team, providing extraordinary virtual primary care with expert clinical skills and an empathic approach. They help us deliver industry-leading outcomes by managing patients as part of a robust multidisciplinary team alongside primary care physicians, registered nurses, health guides, and other cross-functional colleagues. This is a great opportunity for a Nurse Practitioner who thrives in an innovative, collaborative environment and is interested in helping us build the future of tech-enabled advanced primary care. You will: Provide comprehensive virtual primary care across geographies, managing a broad range of conditions from chronic disease management and preventative care to acute episodic care. Act as a champion for evidence-based clinical approaches, maintaining expertise in primary care through continuous learning and professional development. Ensure high patient satisfaction by delivering care with an empathetic approach and a relentless focus on quality. Collaborate with internal and external physicians as clinically necessary and with supervising physicians as may be required by state guidelines Partner with licensing & credentialing to proactively maintain and expand licensure status across the country, as may be needed by the practice Work independently in a remote setting from a private, HIPAA-compliant home office. Be timely with visit shifts, documentation, and communication while maintaining excellent attendance Participate in on-call rotation to ensure 24/7 patient access to care You’d be a good fit if you have: Graduated of an accredited Master’s or Doctoral Nurse Practitioner (NP) program National certification as a Family Nurse Practitioner (FNP) or Adult Nurse Practitioner (ANP) through AANP or ANCC Active and unencumbered Nurse Practitioner (NP) license Active RN compact license Active multi-state NP licensure (5+ licenses preferred) Active federal DEA registration Minimum 2+ years experience in primary care Ability to function within a multidisciplinary team Excellent communication, patient engagement, and collaboration skills Proficiency with technology and the ability to quickly learn new software platforms. It’d be nice if you have: Active multi state licenses 10+ Prior virtual-based care experience Experience in Value-Based Care The salary range for this position is $130,000 to $150,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Firefly Health is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment. Our office is in Watertown, Massachusetts, but we’ve developed a robust remote working structure to give us more geographical flexibility while hiring for many positions. This role can be done largely remotely, there are several times a year when staff come together onsite for planning and team building. Firefly is an equal opportunity employer. We value diverse backgrounds and perspectives. We're committed to building and sustaining an inclusive workplace culture where individuals are treated with dignity and respect. All employment is decided on the basis of qualifications, merit, and business need. Firefly is an E-Verify employer.

MinuteClinic Virtual Care Nurse Practitioner - PRN

CVS Health TN

$37.66 - $81.11 / hour

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. This is a 6-month PRN contract position; provider must be able to provide a minimum of 9 hours of availability per week including every third weekend. The available shifts are for evening and overnight hours. Qualified candidates must hold a current, unrestricted license in Tennessee and live within three hours of the Tennessee border to meet minimum qualifications for this position. If hired, must be willing and able to obtain additional licensure. Internal candidates cannot maintain a full-time or part-time position in core and a PRN position in Virtual Care. The MinuteClinic Virtual Care Nurse Practitioner (Provider) delivers patient care services through a remote technology platform. You will work in collaboration with a dedicated team of professionals as you independently provide holistic, evidenced based care inclusive of accurate assessment, diagnosis, treatment, management of health problems, health counseling, and disposition planning for our patients ranging in age 18 months and above. Encounters are documented utilizing Epic. WORKING ENVIRONMENT: Dedicated virtual care providers must meet minimum requirements for remote care delivery, including: broadband connectivity, a quiet setting with a neutral background to conduct visits from, and the ability to uphold patient privacy per CVSH guidelines. Ability to hardwire into connection preferred. While performing the duties of the job, the employee is regularly required to interact with customers in a remote manner, site, write, operate the computer and phone, speak intelligibly, and hear patient responses. Specific vision abilities include the ability to view and read a computer screen and other electronic devices Responsibilities: Provide holistic, evidenced based care inclusive of accurate assessment, diagnosis, treatment, management of health problems, health counseling, and disposition planning for our patients. This includes education and treatment for pregnancy prevention, STI Prevention and safer sex practices. Evaluate primary care, acute, chronically ill, and transitional care patients, in addition to providing healthcare education and counseling, and disposition planning for our patients ranging in age 18 months and above. Provide patient counseling; inclusive of pregnancy prevention, STI Prevention/safer sex practices, contraceptive care counseling and medication management Educate patients on health maintenance and respond to patient care inquiries Document all patient care within an EHR according to MinuteClinic policies and procedures Provide care and coordination of our patients with internal and external colleagues, including the broader patient centered medical home, ensuring the highest standard of care is provided for all patients. Effectively work within a patient care team, including fellow Providers, Collaborative Physicians, paraprofessionals, Pharmacists and other members of the health care team Work independently , prioritize and solve problems, take initiative, and advocate for their patients and their practice Required Qualifications: Candidates must be currently licensed in one of the following states to be considered: Tennessee Minimum of two years of medically-relevant experience or equivalent Effective verbal, written, and electronic communication skills Outstanding organizational skills and ability to multi-task Initiative, problem solving ability, adaptability and flexibility Ability to work without direct supervision and practice autonomously Is proficient with information management and technology Capacity to collaborate with professional colleagues as necessary to provide quality care Depending on the market, the ability to be proficient in both speaking and writing in additional languages not limited to but including Spanish may be required Education: Completion of a Master’s Degree level Family Nurse Practitioner program with current National Board Certification and State of Employment license to practice in the Advanced Practice Nurse role required Pay Range The typical pay range for this role is: $37.66 - $81.11 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 part‑time position is eligible for a range of benefits and programs that support the physical, emotional, and financial well‑being of colleagues. Depending on hours worked and eligibility, the benefits for this position include dental, vision, wellness resources, employee discounts, access to certain voluntary benefits, and other programs. 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: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Clinical Triage Specialist (RN) - Rheumatology/Infectious Disease/Pulmonary (PA & NJ Residents Only)

St. Luke's University Health Network Allentown, PA

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Clinical Triage Specialist (CTS) (RN) - Access Center will compassionately deliver an exceptional patient experience and provide clinical support to CTS-MA team members by serving as a clinical resource. The CTS-RN is responsible for using nursing judgment in answering/returning patient calls related to direct care provided by the practices. When appropriate, the caller’s symptoms will be assessed and triaged using approved nursing protocols and guidelines to assist in obtaining the appropriate level of care and/or self-care advice. JOB DUTIES AND RESPONSIBILITIES: Answers telephones, prioritizes clinical triage calls, follows clinical protocols, and coordinates services, as needed. Verifies patient demographic information and accurately enters the updated information into electronic health record. Serves as an escalation point for clinical patient issues and other POD team members requiring clinical support, and provides clinical advice based on clinical protocols and procedures. Manages and responds to escalated electronic patient messages whenever not answering inbound patient calls and uses clinical judgment to prioritize and accommodate patients. Creates a positive patient experience at every encounter, attempting to independently resolve any issues or concerns of the patient at the time of the phone call, within the scope of the role. Consistently meets productivity, schedule adherence, and quality standards as set by the Access Center. Utilizes all resources and guidelines at his/her disposal to effectively assess, prioritize, advise, schedule appointments, or refer calls when necessary to the appropriate medical facility or personnel. Accurately documents symptoms/complaints, nursing assessment, advice provided and patient/caller response. Partners with other Access Center teams/PODs and respective practice clinical team on behalf of the patient to assist with clinical concerns, medication refills, or scheduling appointments. Other duties as assigned. EDUCATION: Graduate of an accredited nursing program. Active Registered Nurse licensure in the state of Pennsylvania and New Jersey or other nursing compact state and other states as deemed necessary by state law. TRAINING AND EXPERIENCE: Minimum 2 years recent clinical experience in a physician office, home health, critical care and/or emergency room is required. Strong communication skills Focused on compliance Demonstrates continuous growth Quality-driven Service-oriented Excels at time management Strong problem-solving skills Ability to work from home in accordance with the Network Work from Home Policy if needed. Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.

RN | Triage Call Center | PRN Status

Logan Health Kalispell, MT

This position provides primary care to patients, including assessment, treatment, care planning, and medical care evaluation. Our Mission : Quality, compassionate care for all. Our Vision : Reimagine health care through connection, service and innovation. Our Core Values : Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence. Logan Health is looking for an RN to be part of our Triage team! What you'll be doing: Provide telephone-based clinical triage and symptom assessment Determine appropriate level of care and next steps Review patient history and document accurately and timely in the EMR Collaborate with providers and clinical care teams Educate patients and deliver clear instructions Prioritize urgent and high-risk calls Manage message routing and escalation Work efficiently in a fast-paced, multitasking call center environment Qualifications: Current Montana RN license or a multi state compact license with authorization to practice nursing within the state of Montana; required. BSN degree preferred. Minimum of two (2) years’ experience in similar position within a medical setting (eg, physician office, clinic, or hospital) required. Experience in assigned area(s) preferred. Possess knowledge of professional nursing theory, medical terminology and principles of professional nursing practice to administer and evaluate patient care. Healthcare Provider (HCP) CPR and/or BLS certification required as dictated by each practice/service line. Additional certifications may be required as applicable to assigned area(s). Understanding of the confidentiality laws that govern the provider-patient relationship, including but not limited to, HIPAA guidelines. Knowledge of equipment, supplies, and instruments used in a medical office; simple routine clinical laboratory methods, universal blood and body fluid precautions. Must have knowledge of OSHA rules and regulations, established protocol for storing poisons, narcotics, acids, caustics, and flammable items; restriction imposed by various manage care carriers, various forms inherent to profession. Job Specific Duties: Develops, implements and coordinates individualized, goal directed nursing care to patients through the use of the nursing process as appropriate for RN’s as applicable to the assigned area(s). Maintains nursing standards of care and responds to changing workloads and patient conditions by: remaining calm, making objective assessments, prioritizing, and asking for assistance as appropriate. Transcribes and implements provider orders and treatments both verbal and written accurately and efficiently as noted by chart reviews and observation. Consistently problem solves issues affecting patient care. Exhibits a thorough practice of infection control procedures per policy and procedure as applicable to the assigned area(s). Identifies, verbally evaluates, and reports identified reaction changes in the stated physical and mental conditions of patients. Documents all encounters with patients seeking health advice according to organizational standards, while clearly demonstrating the nursing process. Provides individual instruction and education to patients and families concerning health and medical needs per department protocol and as applicable to assigned area(s). Assesses and anticipates the needs of the patient, and coordinates the necessary interventions as defined by policy, procedure and the written/verbal orders of the provider as applicable to assigned area(s). Consistently problem solves issues effecting patient care. The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not all of the duties may be assigned to a position. Maintains regular and consistent attendance as scheduled by department leadership. Shift: Day Shift - 10 Hours (United States of America) PRN / Casual status. Hours will vary and are scheduled as needed to support departmental and patient care needs. PRN positions (also referred to as Casual, As Needed, or Per Diem) at Logan Health offer flexibility and are designed to provide coverage during busy periods, employee absences, and vacations, making them an excellent opportunity to support the team as needed. PRN employees can participate in a matching 401(k) plan and have access to the Employee Assistance Program. Additionally, they may qualify for hourly differential pay for certain shifts or hours, offering extra compensation based on department-specific scheduling needs. Pay rates and scheduling practices may vary by department. Notice of Pre-Employment Screening Requirements If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes: Criminal background check Reference checks Drug Screening Health and Immunizations Screening Physical Demand Review/Screening Equal Opportunity Employer Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.

Utilization Management Nurse Specialist RN II

L.A. Care Health Plan Los Angeles, CA

$88,854 - $142,166 / year

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner. Duties Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment. Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy. Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network. Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner. Perform other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 5 years of varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management services organization. Experience with Managed Medi-Cal, Medicare, and commercial lines of business. Skills Required: Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials. Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team Excellent time management and priority-setting skills. Maintains strict member confidentiality and complies with all HIPAA requirements. Strong verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light Additional Information May work on occasional weekends and some holidays depending on business needs. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)

RN | Triage Call Center | PRN Status

Logan Health Kalispell, MT

This position provides primary care to patients, including assessment, treatment, care planning, and medical care evaluation. Our Mission : Quality, compassionate care for all. Our Vision : Reimagine health care through connection, service and innovation. Our Core Values : Be Kind | Trust and Be Trusted | Work Together | Strive for Excellence. Qualifications: Current Montana RN license or a multi state compact license with authorization to practice nursing within the state of Montana; required. BSN degree preferred. Minimum of two (2) years’ experience in similar position within a medical setting (eg, physician office, clinic, or hospital) required. Possess knowledge of professional nursing theory, medical terminology and principles of professional nursing practice to administer and evaluate patient care. Healthcare Provider (HCP) CPR and/or BLS certification required as dictated by each practice/service line. Additional certifications may be required as applicable to assigned area(s). Understanding of the confidentiality laws that govern the provider-patient relationship, including but not limited to, HIPAA guidelines. Minimum of two (2) years’ RN experience in a similar position within a medical setting (e.g. physician office, clinic, or hospital) required. Experience in assigned area(s) preferred. Knowledge of equipment, supplies, and instruments used in a medical office; simple routine clinical laboratory methods, universal blood and body fluid precautions. Must have knowledge of OSHA rules and regulations, established protocol for storing poisons, narcotics, acids, caustics, and flammable items; restriction imposed by various manage care carriers, various forms inherent to profession. Understanding of the confidentiality laws that govern the provider-patient relationship, including but not limited to HIPAA guidelines. Excellent organizational skills, detail-oriented, a self-starter, possess critical thinking skills and be able to set priorities and function as part of a team as well as independently. Commitment to working in a team environment and maintaining confidentiality as needed. Excellent verbal and written communication skills including the ability to communicate effectively with various audiences. Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy. Possess considerable knowledge of the behavior and needs of patients. Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed. Job Specific Duties: Develops, implements and coordinates individualized, goal directed nursing care to patients through the use of the nursing process as appropriate for RN’s as applicable to the assigned area(s). Maintains nursing standards of care and responds to changing workloads and patient conditions by: remaining calm, making objective assessments, prioritizing, and asking for assistance as appropriate. Transcribes and implements provider orders and treatments both verbal and written accurately and efficiently as noted by chart reviews and observation. Consistently problem solves issues affecting patient care. Exhibits a thorough practice of infection control procedures per policy and procedure as applicable to the assigned area(s). Identifies, verbally evaluates, and reports identified reaction changes in the stated physical and mental conditions of patients. Documents all encounters with patients seeking health advice according to organizational standards, while clearly demonstrating the nursing process. Provides individual instruction and education to patients and families concerning health and medical needs per department protocol and as applicable to assigned area(s). Assesses and anticipates the needs of the patient, and coordinates the necessary interventions as defined by policy, procedure and the written/verbal orders of the provider as applicable to assigned area(s). Consistently problem solves issues effecting patient care. The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not all of the duties may be assigned to a position. Maintains regular and consistent attendance as scheduled by department leadership. Shift: Day Shift - 10 Hours (United States of America) Schedule: Logan Health operates 24 hours per day, seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. PRN positions (also referred to as Casual, As Needed, or Per Diem) at Logan Health offer flexibility and are designed to provide coverage during busy periods, employee absences, and vacations, making them an excellent opportunity to support the team as needed. PRN employees can participate in a matching 401(k) plan and have access to the Employee Assistance Program. Additionally, they may qualify for hourly differential pay for certain shifts or hours, offering extra compensation based on department-specific scheduling needs. Pay rates and scheduling practices may vary by department. Notice of Pre-Employment Screening Requirements If you receive a job offer, please note all offers are contingent upon passing a pre-employment screening, which includes: Criminal background check Reference checks Drug Screening Health and Immunizations Screening Physical Demand Review/Screening Equal Opportunity Employer Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status, race, color, gender, sexual orientation, religion, national origin, age, disability or any other basis protected by applicable law. If you require accommodation to complete the application, testing or interview process, please notify Human Resources.

Bilingual LPN Care Coach - Bonus Eligible

CircleLink Health

$9 - $11 / visit

This is a remote role. CircleLink Health is looking for passionate, tech savvy nurses to work remotely and serve patients enrolled in Medicare’s Chronic Care Management Program. In this part time role (about 20-25 hrs. per week), an LPN Care Coach will be assigned a group of patients that they will be following and calling each month. In these monthly calls you will provide education, coordinate care, close preventive care gaps, and coach on strategies for self-management to keep them out of the hospital. This Role Requires Precision, Discipline, and Accountability The Care Manager role is not a step back from bedside nursing — it’s a step into a more complex, structured, and performance-driven environment. To succeed, you must bring more than clinical knowledge: ✅ Excellent documentation skills — Your charting must be complete, timely, and accurate. ✅ Strong time management — Case tasks must be prioritized and closed on schedule. ✅ Ownership of outcomes — Each case is closely tracked for quality, compliance, and effectiveness. Expectations are high, and performance is regularly reviewed. This is not a role where details can be missed or timelines pushed — we need professionals who take initiative, stay organized, and consistently deliver. If you’re ready for a challenging, fast-paced environment where your work is held to high standards and makes a real difference, we encourage you to apply. Key Responsibilities: Utilize our specialized care management software to call Medicare patients with 2 or more chronic conditions (Diabetes, CHF, Chronic Pain, COPD, etc.) on a monthly basis Build and maintain rapport with patients to help coach them to improved health through SMART goals and education on self-management strategies Implement and improve the Plan of Care by updating medications, appointments due, biometrics, symptoms, and interventions made Connect the patient with community resources as needed, including transportation, personal care needs, prescription/DME assistance, social services, etc. Conduct Transitional Care Management activities to high risk patients discharged from the hospital and the ER to reduce unnecessary readmissions. Close care gaps by encouraging and assisting with preventive care measures, i.e. annual well visits, vaccines, cancer screens, follow-up/specialist appointments, etc. Fluent in both English and Spanish is a must. Self-directed, able to work independently with little supervision while meeting performance metrics Passion for nursing and improving patient outcomes Good with technology and eager to learn and use new software Excellent organizational and time management skills Timely communication is essential, and nurses are expected to respond to all messages and emails within 24–48 hours. Strong critical thinking and problem-solving skills Education and Experience: Current, unrestricted Multistate LPN or New Mexico LPN license is required. If you are not sure, please check your nursing license on www.Nursys.com Proficiency with EPIC electronic health record and web-based applications is a must. 3-5+ years' experience as a nurse Preferred Education and Experience, but not required: Case Management or Chronic Disease Management experience highly preferred Certified Diabetes Educator Experience with Motivational Interviewing or other behavior change communication techniques Scheduling and other Requirements LPN needs a STRONG internet-connected computer and this will be tested You must have a minimum of 20 hours of availability per week between the hours of 8 am and 5 pm MST, Monday- Saturday. You will not have to work every day-your schedule will be flexible. Each LPN will commit to their own schedule using our software This is a 1099 contract position with no end date. Care coaches are responsible for their own equipment, taxes and insurance. Compensation: LPN Care Coach compensation is paid at the rate of $11.00 for the first 20-minute increment (20-min milestone), $9.50 for the second 20-minute increment (40-min milestone), and $9.00 for the 3rd 20-minute increment (60-min milestone). A clinical encounter occurs after two criteria are met:1/ A successful interactive clinical call with the patient or their caregiver. 2/ A 20-min, or 40-min, or 60-min milestone is met on the patient's chart. Example pay scenarios, but not limited to: Two 20-min successful calls with 2 different patients pays $22 for the two 20-min visits. ($11+$11=$22.00) A 40-min encounter with the same patient pays $20.50. ($11+$9.50=$20.50). A 60-min encounter with the same patient pays $29.50. ($11+$9.50+$9=$29.50) Bonus Eligibility: Coaches who successfully complete THREE months of employment and meet all performance expectations will be eligible for a $300 performance bonus. Pay Timing: Monthly via direct deposit, 40 days after the last day of the first month of service. This is due to the time it takes Medicare to process reimbursements, audit documentation, etc. Thereafter, you will be paid approximately every 30 days after each month. About CircleLink Health: CircleLink Health is a company of passionate clinicians, technologists and businesspeople tackling the $600B problem of preventable chronic and post-acute complications. We’re building a world-class Care Management platform to enable providers while accelerating the shift to preventative care instead of status quo reactive care. Learn more about us here.

Care Management Specialist

CVS Health MO

$21.10 - $36.78 / hour

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. Job Purpose and Summary As an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly those with social determinants of health (SDoH) needs and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants to support the member in maintaining optimal health. This is achieved by evaluating the members’ needs through the completion of the annual Health Risk Assessment Survey, addressing SDoH needs, and closing gaps in preventative and health maintenance care. Key Responsibilities Telephonic Engagement: Dedicate 50-75% of the day to engaging with members and coordinating their care. Member Outreach: Utilize all available resources to connect with and engage “hard-to-reach” members. Care Planning: Partner with members to develop individualized care plans that encompass goals and interventions to meet their identified needs. Documentation: Maintain meticulous documentation of care management activities in the member’s electronic health record. Collaboration: Work with the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition. Resource Connection: Identify and connect members with health plan benefits and community resources. Regulatory Compliance: Meet regulatory requirements within specified timelines. Consults with the Care Manager RN within the Care Team for clinical knowledge, medication regimes, and supportive clinical decision making Collaborates and leverages the Care Manager RN clinical expertise to ensure members’ needs are adequately addressed. Additional Responsibilities: Support team objectives, enhance operational efficiency, and ensure 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 Performance Metrics: Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements. Professional Conduct: Conduct oneself with integrity, professionalism, and self-direction. Care Management Knowledge: Experience or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. Community Resources: Familiarity with community resources and services. Healthcare Technology: Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records. Collaboration: Maintain strong collaborative and professional relationships with members and colleagues. Communication Skills: Communicate effectively, both verbally and in writing. Customer Service: Excellent customer service and engagement skills. Required Qualifications 2+ years of experience in a health-related field 2+ years of customer service experience Technical Proficiency: Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) and ability to effectively utilize these tools within the CMS role. Work Environment: Access to a private, dedicated space to conduct work effectively to meet the requirements of the position. 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 processes Bilingual skills, especially English-Spanish Education Required: Associate’s degree with relevant experience in a health care-related field Or Practical Nurse degree/certificate with active state licensure. Preferred: Bachelor’s degree in healthcare or a related field Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10 - $36.78 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 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 https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/08/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Case Manager - Registered Nurse

CVS Health GA

$54,095 - $116,760 / year

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. 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 40 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 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 https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 05/01/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.