295 Remote Case Manager Jobs (September 2026) - Apply with AI

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 Position Summary/Mission Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for 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. Fundamental Components • Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. • Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits. • Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning. • Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality. • Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members. • Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences • Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. • 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. Travel can be up to 40% of the work week. Required Qualifications • Must reside in the state of Illinois • Must possess reliable transportation and be willing and able to travel up to 40% of the time from home location. Mileage is reimbursed per our company expense reimbursement policy • Minimum 3-5 years clinical practical experience • Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually • Excellent analytical and problem-solving skills • Effective communications, organizational, and interpersonal skills. • Ability to work independently • Effective computer skills including navigating multiple systems and keyboarding • Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications Preferred Qualifications • 2-3 years Care Management, discharge planning and/or home health care coordination experience • Certified Case Manager •Bilingual Education Associate's degree required, bachelor's preferred; along with active and unencumbered Registered Nurse license in the state of Illinois Work from Home Requirements: • You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted. • A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours. • Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live. • The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time). • If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements. Technical and Logistical Requirements: • Device System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency. • Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings. • Collaboration Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace). • Systems Access Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links. • Troubleshooting Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues. • Future Growth: Openness to learning new skills in the future as the workplace environment evolves 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: 08/28/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Posted 3 weeks ago

Rockstar is a mission-driven end-of-life care company reimagining a $23B industry, having quickly become the largest cremation provider in Los Angeles. With a remote team working across continents, they emphasize high standards and deep empathy. The Family Case Manager role involves guiding families through the service lifecycle, managing approximately 100 cases concurrently. The ideal candidate is organized, client-focused, and proficient in coordinating efforts across internal teams to ensure seamless service delivery. The company upholds a disciplined approach to compensation and provides a supportive work environment.

Posted 1 week ago

Meadow is a rapidly growing company reimagining end-of-life care, seeking Family Case Managers to support families through a compassionate full service lifecycle. As primary points of contact, these managers will handle a high volume of cases, ensuring clients receive exceptional care during critical moments. The ideal candidates will be organized, empathetic, and adept at managing communications across various systems. This fully remote position offers the opportunity to work in a collaborative startup environment, contributing to a mission that truly matters.

Posted 1 week ago

Banner Health is seeking a Pediatric RN, Case Manager to join their Maternal Child Health team, focusing on telephonic complex case management. The position involves partnering with families and healthcare providers to coordinate care, addressing barriers to ensure quality health outcomes. This role is remote after an initial training period and emphasizes the importance of patient advocacy and effective communication in healthcare settings. Ideal candidates will have a strong background in nursing and a passion for improving pediatric health.

Posted 3 weeks ago

The Medical Case Manager is responsible for delivering comprehensive case management services to members, focusing on quality, cost-effective health care delivery. This role involves assessing member needs, developing care plans, coordinating services, and monitoring progress. The Case Manager advocates for members' health care needs while ensuring compliance with regulations and improving care efficiency. Additionally, experience in clinical and case management is required, alongside relevant licenses and certifications.

Posted 2 weeks ago

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today! Job Details This role is in support of Cencora’s patient and provider support and pharma commercialization services in Canada marketed through our Innomar Strategies business. This job profile description is a standardized, non-contractual reference description and global reference tool provided for organizational consistency and talent architecture purposes across Cencora. It does not alter actual job duties, responsibilities, reporting lines, working conditions, grading, compensation, or other essential terms and conditions of employment. Actual duties and responsibilities may vary based on business needs, local requirements, and operational practices. Where a team member's role is governed by an employment agreement, local terms and conditions, prior job description or collective bargaining agreement, those documents shall prevail in case of any inconsistency. Mandatory local laws shall also prevail. Responsibilities: Reviews patient files, treatment history, provider inputs, and supporting documentation to confirm readiness for case action and next-step processing. Executes established clinical and operational procedures to support patient enrollment, therapy coordination, case progression, and access to prescribed treatment. Audits case activity, follow-up actions, and documentation quality to identify discrepancies, delays, and process gaps affecting service delivery. Evaluates therapy access barriers, coverage issues, and coordination risks to determine timely escalation and resolution needs. Interprets program protocols, product guidance, and operational requirements to provide clear direction to patients, providers, and internal teams. Stabilizes the patient journey by coordinating with healthcare providers, pharmacies, clinics, and support teams to reduce disruption in therapy access or administration. Upholds adverse event reporting, documentation controls, and communication standards in line with clinical, quality, and regulatory expectations. Education A Diploma in health care or a related field, with a preference for Bachelor’s degree Licensed Nurse (RN or RPN/LPN) with active registration from the College of Nurses in the province of employment is required. Knowledge Skills: Knowledge in clinical operations, care coordination, and case management processes. Knowledge in patient support program workflows and therapy access pathways. Knowledge in clinical documentation, record maintenance, and audit requirements. Knowledge in treatment protocols, therapy administration support, and patient education practices. Knowledge in reimbursement navigation, coverage processes, and funding support activities. Knowledge in adverse event reporting, quality controls, and compliance standards. Work Experience: Ability to interpret clinical, operational, and reimbursement-related information accurately. Ability to evaluate case status, service risks, and barriers to therapy access. Ability to validate documentation and maintain accurate case records. Ability to coordinate across patients, providers, pharmacies, clinics, and internal teams. Ability to communicate complex care and program information clearly and professionally. Ability to stabilize case progression through timely follow-up, escalation, and issue resolution. Ability to audit case activities and identify gaps in process execution or documentation quality. Ability to uphold confidentiality, quality expectations, and regulatory requirements in daily work. ​ What Cencora offers We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. Full time Equal Employment Opportunity Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law. The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory. Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email [email protected] . We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned Accessibility Policy Cencora is committed to fair and accessible employment practices. When requested, Cencora will accommodate people with disabilities during the recruitment, assessment and hiring processes and during employment. This posting is intended to fill an existing vacancy for our Nurse Case Manager role. Affiliated Companies: Affiliated Companies: Innomar Strategies

Posted 3 days ago

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. Join us as we put healthcare on a better path!! As a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team. As an RN Case Manager, the RN will work closely with client and members alike to promote wellness, problem-solve, and assist members in realization of their personal health-care related goals. This role includes telephonic member and provider outreach, data collection and analyzation, reporting, clinical review, medical and behavioral health assessments, and documentation in compliance with Federal/State regulation, NCAQ standard, and company policies and procedures. This position is part of the Value Based Care Services team. WHAT YOU’LL BE DOING Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. Maintaining confidentiality related to all computer programs, medical records, and data. Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. Rotation in off-hour/weekend calls if applicable. Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. Other responsibilities as assigned and per any changes in annual program requirements. WHAT YOU'LL NEED TO HAVE Current IL Registered Nurse License (State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle). Minimum of five years of experience in a variety of health care settings. Highly experienced in Case Management and Chronic Condition Management. Knowledge of utilization review, quality improvement, managed care, and/or community health. Previous remote and/or telephonic work experience. Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing. Excellent clinical judgment, as well as highly skilled in verbal and written communication. Strong organizational. problem solving, and time management skills necessary. Ability to ensure timely completion of projects and assignments. Ability to prioritize and react based on rapidly changing business needs. Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. Experience navigating multiple EMR’s. A high speed/secured home internet connection, a private HIPAA compliant home office with a door that locks for security and privacy purposes, and back-up connection service options for internet outages. WHAT WE'D LOVE FOR YOU TO HAVE Certification in Case Management preferred but not required The salary range for this role is $90,000.00 ALIVE with Purpose: How We Thrive at Guidehealth At Guidehealth, our values come to life in everything we do. We are Driven by A ccountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always L earning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative I nnovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every V oice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through E mpathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth. BENEFITS: While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include: Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs. Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered. Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution. Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected. Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times. Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals. Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need. Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us. All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits. COMPENSATION: The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications. OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager. As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements. REMOTE WORK TECHNICAL REQUIREMENTS Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements. SECONDARY EMPLOYMENT At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.

Posted 2 weeks ago

Guidehealth is seeking a Remote RN Case Manager to support patients and families in navigating complex health journeys. This role emphasizes building meaningful relationships, creating personalized care plans, and coordinating care while educating members on the healthcare system. With a strong focus on collaboration and flexibility, candidates should have a minimum of five years of nursing experience and a background in care management. The position allows for remote work and offers a competitive salary, with opportunities for growth and development in a mission-driven team.

Posted 1 week ago

SelectCommunity at BCBST is seeking a Registered Nurse Case Manager who is compassionate about case management, advocating for social, emotional, functional, mental, behavioral, and physical health of those who are intellectually and developmentally disabled. In this role, the SelectCommunity Nurse Care Manager (NCM) assesses members’ current status, facilitates coordination of long-term services and supports under their insurance benefits and benefits under Department of Disability and Aging. The SelectCommunity NCM collaborates with members, caregivers, conservators, and providers to develop individual, integrated plans of care based on health needs, while monitoring progress for members with multiple levels of acuity. This role requires telephonic contacts and in person home visits with members on at least a monthly basis and as required by TennCare Contract. You will be a great match for this role if you have an active RN license in the state of Tennessee along with 5 years of experience in the healthcare field (including 3 years of clinical experience ). Additionally, we’re seeking candidates who reside in Shelby County TN as travel is required to meet with members. Job Responsibilities Supporting utilization management functions for more complex and non-routine cases as needed. Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs. Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation. Digital positions must have the ability to effectively communicate via digital channels and offer technical support. Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. Various immunizations and/or associated medical tests may be required for this position. This job requires digital literacy assessment. Job Qualifications License Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law. Experience 3 years - Clinical experience required 5 years - Experience in the health care industry For Select Community Katie Beckett: 2 years experience in IDD for Select Community is required Skills\Certifications Excellent oral and written communication skills PC Skills required (Basic Microsoft Office and E-Mail) Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times. Number of Openings Available 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

Posted 1 week ago

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. Bilingual Behavioral Health Case Manager (Licensed) 100% Remote | Anywhere in the U.S. | Monday–Friday Business Hours No Nights • No Weekends • No Holidays • No On-Call Are you a licensed behavioral health professional who is passionate about helping members improve their overall well-being? Join our team and use your clinical expertise to support Medicare members through comprehensive care management, behavioral health advocacy, and community resource coordination, all from the comfort of your home. What You'll Do Provide telephonic case management for Medicare members with behavioral health needs Complete comprehensive assessments and develop individualized care plans Utilize Motivational Interviewing techniques to engage members and support positive health outcomes Coordinate care with providers, health plan partners, and community-based resources Assist members in accessing behavioral health, social, and community support services Provide behavioral health consultation and collaboration across internal teams Participate in clinical treatment rounds and interdisciplinary care discussions Contribute innovative ideas to support program development and continuous improvement Maintain accurate documentation within clinical systems WHAT YOU BRING - REQUIRED Active, unrestricted behavioral health license in your state of residence (LCSW, LPC, LMFT, LPCC, LISW, LSW, or equivalent) Master's Degree in Social Work or Counseling 3+ years of recent direct clinical behavioral health experience Experience with crisis intervention and motivational interviewing Bilingual in Spanish and English – read, write, and speak fluently Strong assessment, care planning, and member engagement skills Ability to work independently in a telephonic, computer-based environment High-speed residential internet (minimum 25 Mbps download / 3 Mbps upload) Preferred Qualifications Crisis intervention experience Managed Care, Utilization Review, or Care Management experience Discharge Planning experience Prior Authorization, Concurrent Review, or Appeals experience Certified Case Manager (CCM) certification Experience working with DSNP or Medicare populations Why Join Us? Fully remote position available anywhere in the U.S. Predictable Monday–Friday schedule with no evenings, weekends, holidays, or on-call responsibilities Opportunity to make a meaningful impact on Medicare members' behavioral health outcomes Collaborative, supportive clinical team environment Meaningful work focused on whole-person care and community resource integration If you're a bilingual behavioral health clinician who enjoys care coordination, member advocacy, and improving lives through compassionate clinical support, we'd love to hear from you. Apply today! 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: 09/19/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Posted 2 weeks ago

Job Summary Nurse liaison who coordinates care and communicates pertinent medical information among the Injured Worker, the Insured, and the Carrier to facilitate appropriate treatment, successful rehabilitation, and return to work. Delivers efficient, cost-effective communication for work injuries, MVAs, liability claims, LTD/STD, and other referred services. This is a remote, field-based role that involves regular local travel of up to 2 hours in your region. Duties Responsibilities Follow all policies/procedures in the Case Management (CM) plan; retain accountability for the CM process. Accept referrals as assigned by the Director of Case Management. Make initial contacts per CM plan; schedule initial assessment; obtain date of next physician appointment. Confirm assignment with referral source; clarify special handling instructions. Build professional relationships with clients; treat claimants with dignity. After physician appointments, contact Carrier and Insured per protocol; maintain ongoing communication with Injured Worker, Insured, and Carrier. Record data and billing in CaseAnyplace; submit timely monthly reports (Preliminary, Initial, Progress, Closing). Attend physician appointments; obtain diagnosis, prognosis, treatment plan, rehab length, estimated RTW (modified/regular duty), and MMI/Full Recovery as appropriate. Refer to Vocational Counselor for job analyses (modified/regular duty) when appropriate and approved by Carrier. Recommend IME physicians; coordinate and attend IMEs. Coordinate transportation as needed. Provide translation as needed (for bilingual nurses). Monitor treatment plan; attend therapy sessions when appropriate; maintain contact with therapists for updates. Request transfer of files to Vocational Counselor when appropriate (LMS, Voc Rehab). Assist Carrier/Insured with RTW planning (modified or regular duty). Provide information to Defense Attorneys as appropriate. Promote teamwork with all staff members. Maximize accurate, appropriate billable hours per monthly target (8 hrs/day). Maintain licensure/certifications; complete required annual training on time. Perform additional professional duties as assigned. Retain responsibility for tasks delegated to non-clinical staff. Qualifications Registered Nurse: Current, unrestricted state license; licensed in each state where field case management is provided; able to perform independent assessments within scope. Discipline Eligibility: Practices in a U.S. state/territory allowing independent assessment within scope of practice. Education: Completion of a nursing program and ongoing CE as required. Certification: One or more national certifications within 4 years of hire (e.g., CCM, CRC, CLNC, CRRN) preferred. Experience: Two years FTE direct case management for injured workers or two years under supervision preferred. Benefits Competitive pay and bonus program Health, dental, vision, and retirement plans Flexible scheduling Nurse referral program Continuing education support

Posted 2 days ago

The RN Case Manager plays a critical role in delivering Cigna’s whole‑person health strategy by serving as a trusted advocate and clinical partner for customers, families, and caregivers. This role focuses on care coordination, customer engagement, and health navigation to improve outcomes and deliver exceptional customer experience. The Case Manager demonstrates Cigna’s Care Solutions cultural beliefs , acting with accountability, collaboration, compassion, and innovation in support of both customer needs and business objectives. Candidate MUST live in the Mountain or Pacific Time zone How You’ll Make an Impact Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems. Collaborate with customers and providers to establish goals, interventions, and evidence‑based plans of care. Apply motivational interviewing, behavior change strategies, and shared decision‑making to drive engagement and improved health outcomes. Empower customers to effectively navigate the healthcare system and communicate with providers. Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat). Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole‑person health. Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals. Follow established policies, procedures, and Case Management performance measures. Efficiently navigate multiple systems and applications in a fast‑paced, customer‑focused environment. Complete required training and maintain clinical knowledge, licensure, and certifications. Required Qualifications Active, unrestricted Registered Nurse (RN) license in your state of residency. Minimum of two (2) years of full‑time direct patient care experience as an RN. Candidate MUST live in the Mountain or Pacific Time zone Preferred Qualifications Specialty case management experience, with ONCOLOGY experience preferred for specialty roles. Ability to obtain a URAC‑recognized Case Management certification within four (4) years of hire. Strong clinical judgment with the ability to assess risk, prioritize care, and act decisively. Excellent verbal and written communication skills across phone and digital platforms. Proficiency in Microsoft Word, Excel, Outlook, and online research tools. Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations. Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here . About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Posted 3 weeks ago