Registered Nurse – Care Management (Remote) (Day Schedule)

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 h

Job Title: Registered Nurse – Care Management (Evening & Overnig Location: 100% Remote - United States Employment Type: Full-Time W2 Hourly Compensation: $40 per hour We've increased our pay rate for this role - now $40/hour, up from $35/hour! Compact Multi-State Licensure Required CareTalk Health is a virtual medical practice that specializes in Clinical Process Outsourcing (CPO). We partner with healthcare organizations to build and manage patient and member populations. About the Role CareTalk Health is seeking experienced and highly organized Registered Nurses to join our virtual care team. This fully remote role blends care management, care navigation, and Annual Wellness Visit (AWV) chart preparation, supporting providers in delivering comprehensive, compliant, and patient-centered care. The RN Care Manager will manage medically complex patients, develop and monitor care plans across multiple programs (CCM, RPM, RTM, APCM), complete AWV chart preparation, and actively work to close care gaps, coordinate orders, and support preventive and chronic care initiatives. This role requires strong clinical judgment, excellent documentation skills, comfort with telehealth workflows, and the ability to work independently across multiple platforms. Schedule & Compensation 40 hours per week Evening Shift : 2:30 PM - 11:00 PM EST Night Shift: 11:00 PM - 7:30 AM EST Weekend Requirement: All shift options include every other Saturday and Sunday Rotating holidays What You’ll Do Annual Wellness Visit (AWV) Chart Preparation · Prepare comprehensive AWV charts to support provider efficiency and CMS compliance. · Review and summarize with patients in face-to-face virtual visits via Zoom: · Medical, surgical, and family histories · Medication lists and adherence · Preventive screenings and immunizations · Cognitive, functional, and depression assessments · Identify overdue screenings, risk factors, and care gaps prior to visits. · Commun

Job Title: Registered Nurse – Virtual Care & Care Management (Remote) Location: 100% Remote - United States Employment Type: Full-Time W2 Hourly Compensation: $40 per hour We've increased our pay rate for this role - now $40/hour, up from $35/hour! Compact Multi-State Licensure Required CareTalk Health is a virtual medical practice that specializes in Clinical Process Outsourcing (CPO). We partner with healthcare organizations to build and manage patient and member populations. About the Role CareTalk Health is seeking experienced and highly organized Registered Nurses to join our virtual care team. This fully remote role blends care management, care navigation, and Annual Wellness Visit (AWV) chart preparation, supporting providers in delivering comprehensive, compliant, and patient-centered care. The RN Care Manager will manage medically complex patients, develop and monitor care plans across multiple programs (CCM, RPM, RTM, APCM), complete AWV chart preparation, and actively work to close care gaps, coordinate orders, and support preventive and chronic care initiatives. This role requires strong clinical judgment, excellent documentation skills, comfort with telehealth workflows, and the ability to work independently across multiple platforms. Schedule & Compensation · 40 hours per week · Core coverage Monday–Friday 9:00am–6:00pm EST · 1 Saturday per month (10:00am-4:00pm EST) · Rotating holidays What You’ll Do Annual Wellness Visit (AWV) Chart Preparation · Prepare comprehensive AWV charts to support provider efficiency and CMS compliance. · Review and summarize with patients in face-to-face virtual visits via Zoom: · Medical, surgical, and family histories · Medication lists and adherence · Preventive screenings and immunizations · Cognitive, functional, and depression assessments · Identify overdue screenings, risk factors, and care gaps prior to visits. · Communicate concise patient summaries and key findings to providers before eac

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. Registered Nurse - Utilization Management (Remote) Make a difference in patient care while leveraging your clinical expertise in a dynamic, collaborative environment. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you will review clinical information, apply evidence-based criteria, and collaborate with providers to ensure members receive appropriate, high-quality healthcare services and benefits. What You'll Do Review and assess clinical information to support coverage determinations and care coordination Apply clinical guidelines, policies, and professional judgment to utilization management decisions Collaborate with providers and interdisciplinary teams to facilitate appropriate treatment and services Identify opportunities for care management referrals and member support programs Promote quality, cost-effective healthcare delivery and benefit utilization Provide utilization management expertise and support to internal and external stakeholders What We're Looking For Required Active, unrestricted RN license in your state of residence Minimum 2 years of RN experience in an adult acute care or critical care setting Associate Degree in Nursing (ADN) Strong communication, multitaski

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. Registered Nurse (RN) - Utilization Management Location: Remote (Preference for candidates in Central or Eastern Time Zones) Schedule: 24/7 operation; includes evenings, weekends, and holidays Are you an experienced Registered Nurse looking to leverage your clinical expertise in a collaborative, fast-paced environment? Join our Utilization Management team and play a critical role in ensuring members receive appropriate, high-quality healthcare services across the continuum of care. What You'll Do Review and assess clinical information to support coverage determinations and care recommendations. Apply clinical guidelines, policies, and professional judgment to utilization management decisions. Collaborate with providers and interdisciplinary teams to coordinate care and treatment plans. Identify opportunities for care management referrals and enhanced member support services. Promote quality outcomes, effective healthcare utilization, and member-centered care. Serve as a clinical resource for internal and external stakeholders. Required Qualifications Active, unrestricted RN license in your state of residence. 2+ years of RN experience in adult acute care or critical care settings. Associate Degree in Nursing (ADN). Strong communication, critica

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. Remote RN Case Manager (Case Management & Utilization Management) Aetna National Medical Excellence (NME) is seeking an experienced Registered Nurse (RN) Case Manager to join our growing team. This is a fully remote opportunity open to candidates nationwide, with preference given to nurses residing in compact licensure states . In this blended role, you will combine Case Management and Utilization Management expertise to support members with complex healthcare needs. You'll partner with members, providers, and interdisciplinary teams to develop personalized care plans, improve health outcomes, reduce barriers to care, and promote overall wellness. What You'll Do Assess, coordinate, and manage care for members with complex medical needs Develop proactive care plans to improve short- and long-term health outcomes Identify clinical, social, and functional barriers impacting care Collaborate with healthcare providers and multidisciplinary teams Utilize clinical judgment to support effective utilization and care management decisions Engage members through telephonic care management and health coaching Required Qualifications Active, unrestricted Compact RN license in state of residence 5+ years of RN clinical practice experience 2+