Case Manager Registered Nurse - Field - Must reside in Atlantic City/Cape May

CVS Health; Wildwood (NJ); On-site; USD 72,000 - 156,000; Full time

Job summary

CVS Health is seeking a Case Manager Registered Nurse to provide high-quality healthcare to members in Atlantic City/Cape May. The role involves conducting assessments, developing care plans, and collaborating with healthcare providers while traveling 50-75% of the time. Candidates must have an active RN license and relevant nursing experience. This position offers competitive pay, comprehensive benefits, and opportunities for professional growth.

Benefits

401(k) plan with company matching

Wellness programs

Tuition assistance

Flexible work schedules

Paid time off

Qualifications

• Active and Unrestricted RN license in NJ.
• 3+ years clinical practice experience in nursing.
• Proficiency in documentation and use of electronic health records.

Responsibilities

• Conduct face-to-face assessments with members.
• Develop care plans with team and coordinate services.
• Document patient interactions accurately and timely.

Skills

Critical thinking

Assessment skills

Communication skills

Education

Associates Degree in Nursing

Job description

Case Manager Registered Nurse - Field - Must reside in Atlantic City/Cape May

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

Dev elop , im pl emen t, s upport, and pro m ote heal t h service strateg ies, tacti cs, policies, and programs that dr ive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, cli nical cov erage 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 Ca se Manager is respo nsib le f or c ondu c ting fac e t o face visits in the me mbers hom e utilizin g co mprehensiv e asse s sment too ls for memb ers 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 Atlantic/Cape May Counties and surrounding counties.

Required Qualifications

• Active and Unrestricted RN license in NJ
• Must reside in Atlantic or Capy May County NJ
• 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Successful completion (Score of 80% or higher) of the NJ Choice certification is a contingency of employment.

Preferred Qualifications

• LTSS experience
• Managed Care experience
• Crisis intervention skills
• 1+ years of proficiency with using computers and Microsoft Office

Education

• Associates Degree 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

Job description:

Dev elop , im pl emen t, s upport, and pro m ote heal t h service strateg ies, tacti cs, policies, and programs that dr ive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, cli nical cov erage 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 Ca se Manager is respo nsib le f or c ondu c ting fac e t o face visits in the me mbers hom e utilizin g co mprehensiv e asse s sment too ls for memb ers 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 Atlantic/Cape May Counties and surrounding counties.

Required Qualifications

• Active and Unrestricted RN license in NJ
• Must reside in Atlantic or Capy May County NJ
• 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Successful completion (Score of 80% or higher) of the NJ Choice certification is a contingency of employment.

Preferred Qualifications

• Case management and/or discharge planning experience
• LTSS experience
• Managed Care experience
• Crisis intervention skills
• 1+ years of proficiency with using computers and Microsoft Office

Education

• Associates Degree 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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