Case Manager Registered Nurse - Field In Northern New Jersey

CVS Health • Chester, NJ

3d • Remote

About The Position

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. Must Reside in Bergen, Essex, Hudson, Morris, Passaic, Sussex, Union and/or Warren County New Jersey Position Summary 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.

Requirements

• Must reside in the State of New Jersey - Would be assigned a case load based on your location.
• 3+ years’ work experience in pediatric, Special Needs and/or Adult Population
• BSN RN with current unrestricted state licensure in the State of New Jersey
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Face to Face visits in the state of NJ in various settings including, but not limited to in homes, hospitals, provider settings, etc. Travel requirements are subject to change based upon business need.
• Proficient in Multisystem Navigation: Comfortable using multiple monitors and systems simultaneously to streamline tasks and improve efficiency.
• Effective Multitasker: Skilled at talking and typing concurrently while managing various responsibilities with focus and accuracy.
• Basic Technical Troubleshooting: Able to set up and connect essential hardware (monitors, keyboards, etc.) and resolve common technical issues independently.
• Digital Collaboration & Documentation: Experienced in electronic documentation and virtual collaboration tools to support remote teamwork and communication.
• Highly Organized & Results-Oriented: Maintains a structured approach to work, ensuring tasks are completed on time and in alignment with performance metrics.
• Metric-Driven Performance: Demonstrates accountability by consistently meeting or exceeding established goals and expectations.

Nice To Haves

• Case Management experience in an integrated model
• Bilingual preferred.
• Working knowledge of medical terminology.
• Ability to deal tactfully with customers and community.
• Ability to handle sensitive information ethically and responsibly.
• CCM (Certified Case Manager)
• Remote work experience

Responsibilities

• 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.
• establishing a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers.
• monitoring and evaluating the effectiveness of the care plans and adjust the care plan based on clinical judgement and member needs.
• coordinating and collaborating with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery.
• 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.
• mentor new hires once proficient in the role.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees