Case Manager Registered Nurse - Field

Position Overview

At CVS Health, we’re building a world of health around every consumer with a team of dedicated colleagues committed to transforming health care. We are seeking a dedicated Case Manager (RN) to serve members in New Jersey. This role involves significant field travel (50-75%) and follows a Monday-Friday, 8:00 AM-5:00 PM EST schedule.

Location: New Jersey
Schedule: Monday-Friday, 8:00 AM-5:00 PM EST
Salary: $72,627.00
Experience Required: Minimum 3 years of clinical experience in hospital, home health, or ambulatory care settings

Key Responsibilities

• Conduct in-home, face-to-face assessments using comprehensive tools for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE).
• Evaluate non-MLTSS members for service eligibility and support needs, including adult/pediatric medical daycare, personal care assistance, nursing facility services, and MLTSS enrollment.
• Collaborate with members, their representatives, primary care providers, and interdisciplinary care teams to develop and implement individualized care plans.
• Attend and coordinate interdisciplinary team meetings, advocating for safe and appropriate service delivery and discharge planning.
• Authorize services within program benefits in a cost-effective manner.
• Accurately and promptly document all activities in the electronic health record.
• Mentor new hires once proficiency in the role is achieved.

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in New Jersey.
• Minimum of 3 years of clinical experience in hospitals, home health, or ambulatory care settings.
• Willingness and ability to travel 50-75% within New Jersey; must have reliable transportation with mileage reimbursed per company policy.
• Successful completion of the NJ Choice Certification, including a minimum exam score of 80% and completion of required state training modules and field mentoring.
• Proficient in multisystem navigation to effectively use multiple monitors and systems simultaneously.
• Effective multitasking skills, with the ability to talk and type concurrently while managing multiple responsibilities.
• Basic technical troubleshooting skills, including setting up and connecting essential hardware and resolving common technical issues independently.
• Experienced in digital collaboration and electronic documentation tools.
• Highly organized, results-oriented, and capable of managing a clean and efficient workspace.
• Demonstrated ability to consistently meet or exceed established performance metrics.

Preferred Qualifications

• Experience in case management or discharge planning.
• Background in managed care, Medicaid/Medicare, or Long-Term Services and Supports (LTSS).
• Education: Associate Degree or Diploma in Nursing (minimum requirement)

Benefits & Perks

• Comprehensive and competitive mix of pay and benefits, including bonus, commission, or short-term incentive programs.
• Investments in the physical, emotional, and financial wellness of employees and their families.