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

The Muse; Fort Lee (NJ); On-site; USD 72,000 - 156,000; Full time

Job summary

A leading healthcare company is seeking a Case Manager Registered Nurse. This full-time role involves conducting home visits, coordinating care, and utilizing advanced clinical judgment to ensure the delivery of quality health services. The position requires active NJ RN licensure and provides a signing bonus for eligible candidates, along with a comprehensive benefits package.

Benefits

Medical benefits

401(k) plan

Stock purchase options

Wellness programs

Paid time off

Flexible schedules

Qualifications

• 3+ years clinical practice experience required.
• Active NJ RN license mandatory.
• Completion of NJ Choice certification (80%+) required.

Responsibilities

• Conduct face-to-face visits and evaluations in members' homes.
• Coordinate care with members, providers, and care teams.
• Develop care plans and authorize services within cost-effective guidelines.

Skills

Assessment skills

Communication skills

Critical thinking

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

Join to apply for the Case Manager Registered Nurse - Field - Must live in Bergen County New Jersey role at The Muse.

At CVS Health, we're building a world of health around every consumer, with dedicated colleagues passionate about transforming healthcare. As the nation's leading health solutions company, we reach millions of Americans through local presence, digital channels, and over 300,000 purpose-driven colleagues—caring for people where, when, and how they choose, in a way that is more connected, convenient, and compassionate. We do this with heart, every day.

Position Summary:

Signing bonus potential up to $10,000 for eligible external candidates with NJ Choice Certification. This is a remote Case Manager role with 50-75% field travel in Bergen County and surrounding areas. The schedule is Monday - Friday, 8 am - 5 pm EST.

The role involves developing, implementing, supporting, and promoting health service strategies, policies, and programs that ensure quality healthcare delivery. Responsibilities include utilization management, quality management, network management, and clinical coverage. The position requires advanced clinical judgment and critical thinking skills to facilitate appropriate physical, behavioral health, and psychosocial services. The care manager will handle care planning, provider collaboration, and resource utilization in a cost-effective manner. Strong assessment, writing, and communication skills are essential.

Key Responsibilities:

• Conduct face-to-face visits in members' homes using assessment tools for members in MLTSS and/or D-SNP/FIDE programs.
• Evaluate medical needs of non-MLTSS members to promote wellness and service access.
• Complete NJ Choice Certification upon hire; member assignment may include pediatric and complex cases.
• Coordinate care with members, providers, and care teams; attend interdisciplinary meetings.
• Develop care plans and authorize services within the MLTSS/FIDE benefits in a cost-effective manner.
• Document accurately and timely in electronic health records.
• Use critical thinking and problem-solving skills; mentor new hires after proficiency is attained.

Requirements:

• Must reside in Bergen County.
• 3+ years clinical practice experience (hospital, home health, ambulatory care).
• Active NJ RN license.
• 50-75% travel in Bergen County and surrounding areas.
• Completion of NJ Choice certification (score of 80%+ required).
• Own transportation required.

Preferred Qualifications:

• Home health or hospice experience.
• LTSS, discharge planning, managed care, Medicaid, Medicare experience.
• Computer literacy including MS Office Suite.

Education:

• Associate degree or diploma in Nursing minimum.

Additional Details:

Hours: 40/week, Full-time. Pay range: $72,627 - $155,538, depending on experience and other factors. Eligible for bonuses and incentives.

Benefits include medical, 401(k), stock purchase, wellness programs, paid time off, flexible schedules, and more. For details, visit https://jobs.cvshealth.com/us/en/benefits. Application deadline: 06/30/2025.

Qualified applicants with arrest or conviction records will be considered per applicable laws.

Additional Info:

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Healthcare Provider