Case Manager Registered Nurse - Field in New Jersey

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

We are seeking a dedicated Case Manager (RN) to join our team, serving members in New Jersey . This role involves 50-75% field travel and follows a Monday?Friday, 8 : 00?AM?5 : 00?PM EST schedule. The Case Manager will develop, implement, and support health service strategies, policies, and programs that ensure high?quality, cost?effective care for our members. These strategies encompass utilization management, quality improvement, network coordination, and clinical policy development. This position requires strong clinical judgment, critical thinking, and the ability to coordinate physical, behavioral, and psychosocial services.

Key Responsibilities

• Conduct in?home, face?to?face assessments using comprehensive tools for members enrolled in Managed Long?Term Services and Supports (MLTSS) and / or Dual Special Needs Programs (D?SNP / FIDE) .
• Evaluate non?MLTSS members for service eligibility and support needs, including adult / pediatric medical daycare, personal care assistants, nursing facility services, and MLTSS enrollment.
• Collaborate with members, their representatives, primary care providers, and interdisciplinary care teams to develop and implement individualized care plans.
• Attend and coordinate interdisciplinary team meetings, advocating for members to ensure safe and appropriate service delivery and discharge planning.
• Authorize services within program benefits in a cost?effective manner.
• Accurately and promptly document all activities in the electronic health record.
• Mentor new hires upon achieving proficiency in the role.

Required Qualifications

A minimum score of 80% on the exam.

Technical Skills

Preferred Qualifications

Education

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.

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 :

For more information, visit

We anticipate the application window for this opening will close on : 11 / 20 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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