Case Manager Registered Nurse - Field (Monmouth/Ocean Counties,New Jersey)

CVS Health; New Jersey; Remote; USD 67,000 - 143,000; Full time

Job summary

CVS Health is seeking an Integrated Care Management (ICM) Case Manager to develop proactive care plans that address identified issues. You will coordinate with members, providers, and community resources to improve wellness within Medicare/Medicaid populations.

The role requires an RN license in NJ, 3+ years clinical experience, and willingness to travel 25-50%. Work is remote with travel; standard business hours apply. Comprehensive benefits are included.

Qualifications

• 3+ years of clinical practice experience.
• Active and unrestricted RN licensure in NJ.
• Willing and able to travel 25-50% using own vehicle.
• Must reside close to or within Monmouth/Ocean Counties, NJ.

Responsibilities

• Evaluate member needs and benefits using clinical tools and data.
• Apply clinical judgment to reduce risk factors in care planning.
• Perform assessments from multiple sources, including claims, to address conditions.
• Refer to clinical resources and coordinate with interdisciplinary team members.
• Collaborate with supervisors and stakeholders to overcome barriers and meet goals.
• Follow case management processes in compliance with regulations and company policies.
• Use motivational interviewing to maximize member engagement and identify health needs.

Skills

Communication skills

Analytical skills

Problem solving

Remote work

Education

Associate's degree

Bachelor's degree

Tools

MS Word

MS Excel

Outlook

PowerPoint

Job description

Location

Location: This role will be work at home with 25-50% travel within Monmouth/Ocean Counties, NJ (50-mile radius from applicants' home).

Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST.

Position Summary

The ICM Case Manager develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness.

Our Mission

Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in markets across the country.

Our Integrated Care Management (ICM) Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for 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. Help us elevate our patient care to a whole new level!

Key Responsibilities

• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Remote Work Expectations

This is a remote role with 25-50% travel required, candidates must have a dedicated workspace free of interruptions. Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Required Qualifications

• Minimum 3+ years of clinical practice experience.
• Must have active and unrestricted RN licensure in the state of NJ.
• Willing and able to travel 25-50% of their time using your own vehicle to meet members face to face in their assigned area.
• Reliable transportation required.
• Mileage is reimbursed per our company expense reimbursement policy.
• The protection and security of our colleagues is paramount. CVS Health encourages it's nurses to meet with members in a public place if they feel that is more appropriate. If needed, security escort is also available.
• Must reside close to or within Monmouth/Ocean Counties, New Jersey.

Preferred Qualifications

• Certified Case Manager is preferred.
• Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred.
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually.
• Excellent analytical and problem-solving skills.
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently.
• Effective computer skills including navigating multiple systems and keyboarding.
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.
• Bilingual Preferred.
• Educational Associate's Degree required.
• Bachelor's degree preferred.

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.

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: 12/05/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.