A1A Case Manager RN - Registered Nurse - NC

$54,095 - $116,760 / year

Position Summary:

This RN Case Manager role is part of Aetna One Advocacy (A1A) and requires in office training and ongoing work in High Point, Nc. There is a requirement to live within a commutable distance of High Point, Nc (typically within 45 minutes maximum).

The expected start date for the cohort is May 11, 2026.

The initial in office training will last for approximately 4 months.

Once office training is complete, the role is work from home with occasional in office workdays scheduled in advance with the employee.

There will be an expectation that the Case Manager works in the office at least one time per quarter for further training but it may be more often and notice will be provided.

Normal Working Hours: 8am-4:30pm EST. Once training is completed, the Case Manager will work occasional later shifts per month on a team rotation. There are no weekend shifts. Flexibility is required for onsite work shifts per the need of the business.

What is A1A? Aetna One Advocate is Aetna’s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors. The high-touch, high-tech member advocacy service combines data-driven processes with the expertise of highly trained clinical and concierge member services. Our mission is to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna, a CVS Health company, in our journey to change the way healthcare is delivered today. We are health care innovators.

The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

RN Case Manager:

– Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.

– Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.

– Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.

– Assessments consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.

– Reviews prior claims to address potential impact on current case management and eligibility.

– Assessments include the member’s level of work capacity and related restrictions/limitations.

– Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.

– Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.

– Utilizes case management processes in compliance with regulatory and company policies and procedures.

– Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required:

- A Registered Nurse that must hold an unrestricted license in their state of residence, preferably with multi-state/compact privileges and be willing and able to be licensed in all non-compact states

- Upon hire, it will be required to obtain all 50 state licenses.

- 3+ years of clinical practice experience required as an RN

- There is a requirement to live within a commutable distance of High Point, Nc (typically within 45 minutes maximum).

Preferred:

- Case Management in an integrated model

- Certified Case Manager (CCM) certification

- Oncology Experience

- Bilingual in English and a 2nd language

Education:

- Associates Degree in Nursing required.

- BSN preferred.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,095.00 - $116,760.00

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: 03/23/2026

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

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Works closely with community-based service providers to identify and address community needs for services and education regarding prevention and/or early detection, medications and first aid available. Provides age/developmentally appropriate patient care in accordance with Age-Specific guidelines for the specific age groups served. SKILLS/QUALIFICATIONS: Requires problem solving, decision making and critical thinking Ability to work in a self-directed environment and with leading teams Demonstrates ability to work in fast-paced environment with multiple interruptions Expertise in MS Office Ability to prepare program reports frequently and efficiently Bilingual preference with fluency in Spanish desirable Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.