Case Manager Registered Nurse (Field Must reside in Somerset County New Jersey)

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

Job summary

A leading health solutions company seeks a Case Manager Registered Nurse for a field role in Somerset County, NJ. The position entails providing health services and support, requiring critical thinking and strong clinical judgment. Candidates must have an active NJ RN license and be prepared for substantial travel within the county.

Benefits

Affordable medical plans

401(k) plan with company matching

Tuition assistance

Qualifications

• 3+ years clinical practice experience required.
• Must hold active NJ RN license.
• Home Health or Hospice experience preferred.

Responsibilities

• Conduct face-to-face home visits for assessments.
• Develop and implement care plans with medical teams.
• Coordination and collaboration with healthcare providers.

Skills

Clinical judgment

Critical thinking

Assessment skills

Communication

Education

Associate degree or Diploma in Nursing

NJ Choice Certification

Tools

MS Office Suite

Job description

Case Manager Registered Nurse (Field Must reside in Somerset County New Jersey)

Join to apply for the Case Manager Registered Nurse (Field Must reside in Somerset County New Jersey) role at The Muse

Case Manager Registered Nurse (Field Must reside in Somerset County New Jersey)

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Join to apply for the Case Manager Registered Nurse (Field Must reside in Somerset County New Jersey) role at The Muse

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 Registered Nurse position is with Aetna's Long-Term Services and Supports (LTSS) team and is a field-based position out of the Somerset County New Jersey. The requirements is for candidates to hold a New Jersey Registered Nurse License, and travel 50-75% of the time to meet with members face to face.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 Somerset County and surrounding counties. Required Qualifications

• Must reside in Somerset County New Jersey
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time within Somerset County and surrounding counties. Mileage is reimbursed per our company expense reimbursement policy
• 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
• 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.
  
  

Preferred Qualifications

• Home Health and/or Hospice Experience a plus!
• 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 Required
  
  

Anticipated Weekly Hours

40Time Type

Full timePay Range

The typical pay range for this role is:$72,627.00 - $155,538.00This 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 peopleWe 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/benefitsWe anticipate the application window for this opening will close on: 06/13/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Technology, Information and Internet

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