CVS Health
CVS Health
CVS Health is an American healthcare company working across healthcare services, health insurance, pharmacy benefits management, and retail pharmacy. Through businesses including Aetna and CVS Caremark, it supports health coverage, prescription access, condition management, specialty medications, and mail-order pharmacy services. Its neighborhood pharmacies and broader care offerings are designed to help people access essential healthcare more conveniently and affordably. CVS Health brings together insurance, pharmacy, and health services to support individuals and communities throughout their care journeys.

Field Registered Nurse Case Manager - Houston Hybrid

CVS Health is seeking a field-based RN case manager to coordinate assessments, individualized care plans, referrals, and member support at Houston Methodist Hospital. The role works with patients, providers, and multidisciplinary teams in a hybrid, hospital-based setting.

Description

  • Act as the primary liaison among members, families, employers, providers, insurers, and healthcare professionals
  • Coordinate case management for members with catastrophic or chronic conditions throughout the care continuum
  • Arrange specialist referrals, home care, community services, and alternative care settings
  • Engage with members by phone and in person while working at Houston Methodist Hospital
  • Meet with members during hospital admissions
  • Evaluate medical, functional, and vocational needs
  • Create and carry out individualized care plans
  • Support benefits eligibility and timely recovery or return to baseline function
  • Communicate with providers, attorneys, employers, and insurance carriers
  • Complete accurate case management records within required timelines
  • Work closely with internal multidisciplinary teams
  • Perform outreach to treating physicians and specialists
  • Deliver education and preventive health guidance
  • Apply rehabilitation and case management laws, regulations, and payer requirements
  • Track member outcomes and revise care plans as needed
  • Create proactive approaches for complex cases and short- and long-term wellness goals

Requirements

  • Hold an active, unrestricted Texas Registered Nurse (RN) license
  • Bring at least three years of clinical experience, preferably serving Medicare and commercial populations
  • Work independently in a hospital-based setting
  • Demonstrate strong analytical, problem-solving, organizational, and communication abilities
  • Use Microsoft Word, Excel, Outlook, PowerPoint, and proprietary clinical applications effectively
  • Navigate multiple computer systems and perform keyboard-based work efficiently
  • Have reliable transportation
  • Consistently meet onsite hospital work requirements at Houston Methodist Hospital for up to 50-75% of the role
  • Hold an Associate's Degree in Nursing or equivalent clinical experience (REQUIRED)
  • Care management, discharge planning, or home health coordination experience is preferred
  • National certification such as CRC, CDMS, CRRN, COHN, or CCM is preferred
  • Comfortably configure and use multiple monitors while working across several applications
  • Communicate through email, calendar invitations, Teams messages, and virtual meetings
  • Experience with Microsoft Office 365 or comparable Google Workspace tools
  • Securely access VPN and EHR portals, lock screens, maintain strong passwords, and identify suspicious emails or links
  • Resolve routine technical problems independently
  • Remain willing to learn new skills as workplace technology and processes change

Benefits

  • Eligibility for a CVS Health bonus, commission, or short-term incentive program in addition to base pay
  • Medical insurance coverage
  • Dental insurance coverage
  • Vision insurance coverage
  • Paid time off
  • Retirement savings opportunities
  • Wellness initiatives
  • Additional physical, emotional, and financial well-being resources, subject to eligibility
  • Company support for obtaining RN licensure in multiple states

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