Case Manager Registered Nurse - Field in New Jersey

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Case Manager Registered Nurse

Location: Multiple Counties Throughout New Jersey

Travel: Approximately 75% travel

Position Summary:

Searching for several compassionate Field Case Manager Registered Nurse (RN) New Jersey.

This field-based role requires approximately 75% travel to conduct in person patient assessments, coordinate multidisciplinary care plans, and facilitate saving transitions between care settings. Combining high day-to-day independence with structured administrative support, this position offers the flexibility of a field schedule alongside the comfort of home-based documentation.

Fundamental Role Components:

• The Case Manager is responsible for conducting face to face visits in the members home utilizing comprehensive assessment tools for members enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE) and non-MLTSS members to evaluate the medical needs of the member to facilitate the member’s overall wellness and help them obtain the services they need to thrive by addressing requests for services such as adult medical daycare, pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment.
• Member assignments may include pediatric population and medically complex cases.
• The case manager schedules and attends interdisciplinary meetings and advocates on the members’ behalf to ensure proper and safe discharge with appropriate services in place.
• The case manager collaborates with the members and care team to develop a care plan and authorizes services in a cost-effective manner within the MLTSS/ FIDE benefit.
• The care manager is responsible for documenting accurately and timely in the member’s electronic health record.
• The case manager is responsible for coordinating and collaborating care with the member/authorized representative, PCP, and any other care team participants.
• This position requires the case manager to use critical thinking skills and the ability to solve problems.
• The Case Manager will also mentor new hires.

Required Qualifications:

• Must reside in New Jersey
• 3+ years of clinical nursing experience
• Active and Unrestricted RN license in NJ
• Must possess reliable transportation and be willing and able to travel 75% of the time. Mileage is reimbursable.
• Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, Successful completion is an exam score of 80% or higher, successful completion of the State training modules, and field mentoring component.

Preferred Qualifications:

• LTSS experience
• Case management, discharge planning and/or Managed Care Experience.
• Medicaid and Medicare experience
• Experience using computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)

Education:

• Minimum associate’s degree or diploma in Nursing required.

Work from Home Requirements:

• You must have or be able to obtain a direct/hardwired internet connection to a modem/router within seven feet of your computer and
• A minimum download speed of twenty-five mbs download and three mbs uploads. Wi-Fi and satellite internet are not acceptable.
• A quiet, secure, and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS.
• Health and HIPAA guidelines and allowing for uninterrupted work during work hours.
• Work-from-Home colleagues must work within the state and city where they have confirmed they currently live.
• The company will provide equipment (keyboard, monitor, computer, headset). All new hires should provide their own.
• workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
• If hired, you will commit to obtaining required internet speeds and adhere to all Work from Home requirements.
• undefined

Technical and Logistical Requirements:

• Device & System Navigation
• Comfortable setting up and using multiple monitors and navigating multiple applications.simultaneously to streamline tasks and improve efficiency.
• Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, andvirtual meetings.
• Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications orsimilar (Google Workspace).

…