Case Manager Registered Nurse (Field - Must reside in Northern New Jersey; Preferably Middlesex[...]

Optum; Bloomfield (NJ); On-site; USD 72,000 - 156,000; Full time

Job summary

A leading health solutions company is looking for a dedicated Case Manager RN in Northern New Jersey. The role includes assessing care management needs, creating tailored care plans, and ensuring services are delivered effectively. Ideal candidates will have a strong nursing background, excellent communication skills, and a commitment to fostering member-centric approaches in healthcare.

Benefits

Affordable medical plan options

401(k) plan with company contributions

Employee stock purchase plan

No-cost wellness programs

Paid time off and flexible schedules

Tuition assistance

Colleague assistance programs

Qualifications

• 3+ years' experience in Pediatric, Special Needs and/or Adult Population.
• Must reside in the Northern part of New Jersey.
• Computer literacy and proficiency with MS Office Suite.

Responsibilities

• Assess and evaluate care needs through telephonic and face-to-face assessments.
• Establish cost-effective and member-centric care plans.
• Coordinate with members and care team for timely service delivery.

Skills

Critical thinking

Problem-solving

Communication

Interpersonal skills

Digital literacy

Education

Bachelor's in Science & Nursing, Social Work, or related field

RN with current unrestricted state licensure in New Jersey

Job description

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

This Case Manager RN position is with Aetna's Integrated Care Management (ICM) team and is a field-based position out of the Northern part of New Jersey, preferablyMiddlesex, Bergen, Essex, Somerset, or Union County NJ. The requirements is for candidates to hold a NJ Registered Nurse License, and travel 50-75% of the time to meet with members face to face.

The care manager is responsible for assessing and evaluating members with potential care management needs through telephonic and face to face assessments in various settings, including the member's private residence, hospitals, behavioral, and long term nursing facilities.

The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers. The care manager monitors and evaluates the effectiveness of the care plans and adjust the care plan based on clinical judgement and member needs. Care managers coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery. The care manager will take an interdisciplinary approach to advocate for member's needs to ensure a safe discharge post hospitalization or transition from a nursing facility, including addressing social needs (e.g., housing and food insecurity). Accurate and timely documentation in the member's electronic health record is essential. The care manager role requires critical thinking, problem-solving skills, and the ability to work autonomously. Additionally, the care manager may be asked to mentor new hires once proficient in the role.

Required Qualifications

• 3+ years' work experience in Pediatric, Special Needs and/or Adult Population
• RN with current unrestricted state licensure in the State of New Jersey
• Must reside in the Northern part New Jersey, specifically in Middlesex, Bergan or Essex County, Somerset, or Union County, or Surrounding Areas
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet with members face to face in Middlesex, Bergan and Essex County. Mileage is reimbursed per our company expense reimbursement policy
• Computer literacy and demonstrated proficiency in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.

Preferred Qualifications

• 2+ years experience managing populations with mental health and/or substance use disorders strongly preferred
• Certified Case Manager Certification
• Case Management experience in an integrated model.
• Bilingual preferred.
• Effective communication skills, both verbal and written.
• Working knowledge of problem solving and decision-making skills.
• Working knowledge of medical terminology.
• Working knowledge of digital literacy skills.
• Ability to deal tactfully with customers and community.
• Ability to handle sensitive information ethically and responsibly

Education

• Bachelor's in Science & Nursing, Social Work, or related field required
• RN with current unrestricted state licensure in the State of New Jersey

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.