Case Manager Registered Nurse - Field - Must live in Bergen County New Jersey

CVS Health; Fort Lee (NJ); Remote; USD 72,000 - 156,000; Full time

Job summary

CVS Health is seeking a Case Manager Registered Nurse to support healthcare delivery in Bergen County, New Jersey. This role involves substantial fieldwork, requiring a keen ability to assess patient needs and coordinate care effectively while collaborating with various health services. Candidates should possess an active NJ RN license, substantial clinical experience, and strong critical thinking skills to thrive in this position. A signing bonus is available for eligible external candidates.

Benefits

Signing bonus potential up to $10,000

401(k) plan with company matching

Affordable medical plan options

Tuition assistance

Flexible work schedules

Qualifications

• Active RN license in NJ required.
• 3+ years in clinical practice like home health.
• Must reside in Bergen County.

Responsibilities

• Conduct face-to-face visits in members' homes.
• Develop and implement care plans.
• Coordinate care with members and health teams.

Skills

Strong assessment skills

Writing skills

Communication skills

Critical thinking

Problem-solving

Education

Associate degree or Diploma in Nursing

Tools

MS Office Suite

Job description

Case Manager Registered Nurse - Field - Must live in Bergen County New Jersey

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Signing bonus potential up to $10,000 for eligible external candidates who possess NJ Choice Certification

This is a remote Case Manager opportunity with 50 to 75% field travel in Bergen County and surrounding counties. The working schedule is Monday - Friday 8am-5pm EST.

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services. The care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. Strong assessment, writing and communication skills are required .

Fundamental Components/Job Description:

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) . Care manager may also be responsible for face to face assessments with 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. Successful completion of company sponsored NJ Choice Certification is requirement for continued employment. Member assignment may include pediatric population and medically complex cases. The case manager is responsible for coordinating and collaborating care with the member/authorized representative, PCP, and any other care team participants. 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 works with the member 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. This position requires the case manager to use critical thinking skills and the ability to problem solve. The Case Manager will also be expected to mentor new hires, once, a level of proficiency has been attained in their role. 50 to 75% travel in Bergen County and surrounding counties.

Required Qualifications

Must reside in Bergen County

3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care

Active and Unrestricted RN license in NJ

50 to 75% travel in Bergen County and surrounding counties

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, an exam score of 80% or higher is required , along with successful completion of the State training modules, and field mentoring component .

Must have OWN transportation

Preferred Qualifications

Home Health and/or Hospice Experience

LTSS experience

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 of Associate degree or Diploma in Nursing

Anticipated Weekly Hours

40

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Signing bonus potential up to $10,000 for eligible external candidates who possess NJ Choice Certification

This is a remote Case Manager opportunity with 50 to 75% field travel in Bergen County and surrounding counties. The working schedule is Monday - Friday 8am-5pm EST.

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services. The care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. Strong assessment, writing and communication skills are required .

Fundamental Components/Job Description:

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) . Care manager may also be responsible for face to face assessments with 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. Successful completion of company sponsored NJ Choice Certification is requirement for continued employment. Member assignment may include pediatric population and medically complex cases. The case manager is responsible for coordinating and collaborating care with the member/authorized representative, PCP, and any other care team participants. 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 works with the member 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. This position requires the case manager to use critical thinking skills and the ability to problem solve. The Case Manager will also be expected to mentor new hires, once, a level of proficiency has been attained in their role. 50 to 75% travel in Bergen County and surrounding counties.

Required Qualifications

• Must reside in Bergen County

• 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care

• Active and Unrestricted RN license in NJ

• 50 to 75% travel in Bergen County and surrounding counties

• 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, an exam score of 80% or higher is required , along with successful completion of the State training modules, and field mentoring component .

• Must have OWN transportation

Preferred Qualifications

• Home Health and/or Hospice Experience

• LTSS experience

• Case management and/or discharge planning experience

• 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 of Associate degree or Diploma in Nursing

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$72,627.00 - $155,538.00

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: 06/30/2025

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

About the company

At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.

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