Case Manager Registered Nurse - Work At Home - San Antonio Texas

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Remote Case Manager RN - Costco Team (San Antonio, TX)

This fully remote Case Manager RN position supports the Costco Team, but candidates must reside within 45 minutes of the local office at 7034 Alamo Downs Parkway, San Antonio, TX 78238, as occasional in-person meetings may be required.
Role Overview:

The Case Manager RN is responsible for assessing, planning, coordinating, and implementing case management activities to support members' overall health and wellness. This includes telephonic and/or face-to-face interactions to evaluate medical needs and develop proactive care plans that improve both short- and long-term outcomes.

• Conduct member evaluations using clinical tools and data to determine needs, benefit eligibility, and care integration.
• Apply clinical judgment to reduce risk factors, address barriers, and resolve complex health and social issues.
• Review prior claims to assess impact on current case management and eligibility.
• Evaluate work capacity and any related limitations.
• Refer members to clinical resources when needed using a holistic approach.
• Collaborate with supervisors and multidisciplinary teams to overcome barriers and improve outcomes.
• Ensure compliance with regulatory and company policies.
• Engage members through effective interviewing techniques to assess health status and needs.

• Active, unrestricted multi-state RN license in Texas.
• Willingness to obtain additional state licenses (company covers expenses).
• Minimum 3 years of clinical RN experience.
• At least 1 year of experience using multiple computer systems and applications (e.g., Microsoft Word, Excel, Outlook).
• Must live within 45 MIN driving distance of the San Antonio office. Must possess reliable transportation and be willing and able to travel up to 10% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Availability to work Monday-Friday, 8:00 AM-5:00 PM CST, with occasional rotation to 10:00 AM-7:00 PM CST as needed.

• Experience in integrated case management.
• Bilingual in Spanish and English.
• Strong computer proficiency.

• Associate Degree in Nursing required.
• BSN preferred.

• 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.