Case Manager, Registered Nurse (New Jersey)

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

Job summary

A leading health solutions company seeks a Case Manager, Registered Nurse in New Jersey. The role involves assessing, planning, and coordinating care management for Medicare members. Ideal candidates will possess strong communication and analytical skills along with the necessary nursing credentials. The successful applicant will collaborate closely with team members to enhance member wellness and navigate their health care needs.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Paid time off and flexible work schedules

Tuition assistance

Qualifications

• Active and unrestricted RN licensure in New Jersey required.
• 3 years of clinical experience preferred in relevant fields.
• Certification as a Case Manager preferred.

Responsibilities

• Assess and coordinate all case management activities.
• Collaborate with healthcare teams and overcome barriers.
• Utilize clinical tools to evaluate member needs.

Skills

Communication

Analytical skills

Problem-solving

Organizational skills

Education

Bachelor's of Science Degree in Nursing

Tools

MS Word

Excel

Outlook

PowerPoint

Job description

Case Manager, Registered Nurse (New Jersey)

Join to apply for the Case Manager, Registered Nurse (New Jersey) role at The Muse

Case Manager, Registered Nurse (New Jersey)

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Join to apply for the Case Manager, Registered Nurse (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 SummaryStandard Working hours Monday through Friday 8:00 AM -5:00 PM Eastern Standard Time (EST)\Must reisde in New JerseyHelp us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our members who are enrolled in Medicare and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in markets across the country. Our Integrated Care Management (ICM) Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.The ICM care manager develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.Additional responsibilities to include but not limited to the following:- Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.

• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborates with supervisor and other key stakeholders in the member's healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
• Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.The protection and security of our colleagues is paramount. CVS Health encourages it's nurses to meet with members in a public place if they feel that is more appropriate. If needed, security escort is also availableRequired Qualifications- Must have active and unrestricted Compact Registered Nurse (RN) licensure in the state of New Jersey
• 3 years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
• 2 years Case Management, Discharge Planning, and/or Home Health Care Coordination experiencePreferred Qualifications- Certified Case Manager
• 2 years Care Management, Discharge Planning and/or Home Health Care Coordination experience
• Bilingual preferred
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
• Change management experience, being able to adapt to change.EducationBachelor's of Science Degree in Nursing 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: 06/20/2025Qualified 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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