Case Manager Registered Nurse - Field in Mercer and Surrounding Counties, NJ

CVS Health; West Windsor (NJ); On-site; USD 67,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Case Manager Registered Nurse to support health service strategies and care coordination for members in New Jersey. The role focuses on utilization management, quality management, and program policies while coordinating with providers and interdisciplinary teams.

The ideal candidate will have an active NJ RN license, at least three years of clinical experience, and Mercer County residency.

Qualifications

• Active, unrestricted RN license in New Jersey.
• Minimum of 3 years of clinical experience in settings such as hospitals, home health, or ambulatory care.
• Residency in Mercer County, NJ
• Must possess reliable transportation and be willing and able to travel up to 75% of the time.
• NJ Choice Certification requirements including exam score, state training modules, and field mentoring.

Responsibilities

• Conduct face‑to‑face home visits and in‑person assessments to determine medical needs and referrals.
• Coordinate and collaborate with members, providers, and interdisciplinary teams.
• Develop individualized care plans and authorize services within MLTSS/FIDE program benefits.
• Document assessments, interactions, and care planning in the electronic health record.

Skills

RN license

Assessment

Documentation

Communication

Travel readiness

Education

Associate degree in Nursing

Job description

Position Summary

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.

Position

Case Manager Registered Nurse

Location

Field in Mercer and Surrounding areas, NJ up to 75% of the time

Schedule

Mon-Fri 08:00-05:00 PM EST

In this role, you will develop, implement, and support health service strategies, policies, and programs that promote high‑quality care for our members. These initiatives include utilization management, quality management, network management, and clinical coverage policies. The position requires advanced clinical judgment, strong critical‑thinking abilities, and the capacity to coordinate physical, behavioral, and psychosocial support services. Responsibilities include care planning, direct collaboration with providers, and effective resource utilization. Strong assessment, written documentation, and communication skills are essential.

Key Responsibilities

• Conduct face‑to‑face home visits using comprehensive assessment tools for members enrolled in Managed Long‑Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D‑SNP/FIDE).
• Perform in‑person assessments for non‑MLTSS members to determine medical needs and support appropriate service referrals (e.g., adult medical daycare, pediatric medical daycare, personal care assistant services, nursing facility custodial care, Personal Preference Program, and MLTSS enrollment).
• Successfully complete and maintain NJ Choice Certification (required for continued employment).
• Work with diverse populations, including pediatric and medically complex members.
• Coordinate and collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams.
• Schedule and participate in interdisciplinary meetings, advocating for members to ensure safe transitions and appropriate services.
• Develop individualized care plans and authorize services within MLTSS/FIDE program benefits in a cost‑effective manner.
• Document all assessments, interactions, and care planning activities accurately and in a timely manner in the electronic health record.
• Utilize strong critical‑thinking and problem‑solving skills in daily work.
• Mentor new staff once appropriate proficiency has been achieved.

Required Qualifications

• Active, unrestricted RN license in the state of New Jersey.
• Minimum of 3 years of clinical experience in settings such as hospitals, home health, or ambulatory care.
• Residency in Mercer County, NJ
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Successful completion of NJ Choice Certification, including:
  • Exam score of 80% or higher
  • Completion of state training modules
  • Field mentoring, as required by the NJ Division of Aging Services

Preferred Qualifications

• Experience in case management and/or discharge planning
• Background in managed care
• Crisis intervention skills

Education

• Minimum of an associate degree in Nursing

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,575.00 - $142,576.00

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 09/30/2026

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