• Responsible for performing care manager duties using established guidelines to ensure appropriate level of care for our members • Coordinate the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care • Evaluate the appropriateness and efficiency of all services designed to meet the member’s needs • Coordinates and assists in implementation of care plan for members • Act as subject matter expert for respective area for mentoring/ preceptor /training/remediation classes • Conduct training and presentations in team meetings and facilitate ad-hoc training activities • Participate in department workgroups to drive internal process changes and efficiencies • Provide reports and feedback on mentees progress to assigned Supervisor as part of the orientation process; assist in the development of plan to identify opportunities for improvement • Act as a subject matter expert and participate in user acceptance testing for medical management system • Evaluates care management processes by problem solving, analyzing variances, and participating in the quality improvement program to enhance trained staff outcomes • Participate in audit activities including IPRO, NCQA, or any other ad-hoc state audits.

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: *Must be RN licensed in New York* 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 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: 04/16/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. The hours for this role will be Monday-Friday, 8:00 AM-5:00 PM in CST Training may be done in EST to align with trainers schedules. Candidates must be located in CST, MST or PST time zones. Position Summary 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. 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 - Requires an active and unrestricted RN licensure - Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members - Minimum 2+ years Case Management, discharge planning and/or home health care coordination experience - Must reside in Central, Mountain or Pacific time zones Preferred Qualifications - Active and unrestricted California RN License - 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 MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications. - Efficient and Effective computer skills including navigating multiple systems and keyboarding - Willing and able to obtain multi state RN licenses if needed, company will provide. - Certified Case Manager - Bilingual in Spanish Education - Associates Degree or Nursing Diploma required - Bachelors Degree preferred 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 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: 04/09/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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 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: 04/16/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.