CVS Health is hiring a Case Manager Registered Nurse to support Long-Term Services and Supports (LTSS) members. In this role, you will perform telephonic and occasional in-person assessments, develop individualized care plans, and coordinate medical, behavioral health, and social services. You will collaborate with providers, community agencies, and caregivers to close care gaps, manage chronic conditions, and reduce hospitalizations. The RN Case Manager documents in care management platforms, ensures regulatory compliance, and educates members and families to improve outcomes and promote independence. Responsibilities Perform telephonic and in-person assessments for LTSS members to determine clinical and social needs Develop and update individualized, person-centered care plans Coordinate medical, behavioral health, and social services with providers and community agencies Monitor member progress, manage chronic conditions, and work to prevent hospitalizations Educate members and caregivers on conditions, medications, and self-management Document all assessments, care plans, and interactions in care management systems accurately and timely Ensure compliance with Medicaid/Medicare, LTSS, and health plan regulatory requirements Collaborate with interdisciplinary teams to close care gaps and support quality metrics Advocate for members' needs, addressing barriers to care such as transportation or housing Participate in performance improvement initiatives and use data to improve care outcomes Required Skills RN case management LTSS/long-term care knowledge Care planning Utilization management Chronic disease management Knowledge of Medicaid/Medicare Electronic health records Interdisciplinary care coordination Regulatory compliance Patient and family education