Case Manager Registered Nurse - Field (Monmouth/Ocean Counties,New Jersey)

CVS Health•Long Branch, NJ

3d•$66,575 - $142,576•Remote

About The Position

The ICM Case Manager develops proactive plans of care to address identified issues, improve short- and long-term outcomes, and support members’ overall wellness. As part of Aetna’s integrated care management team, the case manager serves as a frontline advocate for members enrolled in Medicare and Medicaid who may face complex health and social challenges. The role assesses, plans, implements, and coordinates case management activities to evaluate members’ medical needs and support their wellness. This work-at-home role covers Monmouth and Ocean Counties, New Jersey, with 25–50% travel within the assigned area, typically within a 50-mile radius of the employee’s home. The schedule is standard business hours, Monday through Friday, 8:00 a.m. to 5:00 p.m. Eastern Time. The position requires a dedicated workspace free of interruptions and separate dependent-care arrangements during work hours.

Requirements

At least 3 years of clinical practice experience.
Active, unrestricted RN licensure in New Jersey.
Willingness and ability to travel 25–50% of the time using a personal vehicle to meet members face-to-face in the assigned area.
Reliable transportation.
Residence close to or within Monmouth or Ocean Counties, New Jersey.
Associate degree required.

Nice To Haves

Certified Case Manager credential.
At least 2 years of experience in care management, discharge planning, and/or home health care coordination.
Confidence working from home and independently, using tools to collaborate and connect with teams virtually.
Excellent analytical and problem-solving skills.
Effective communication, organizational, and interpersonal skills.
Ability to work independently.
Effective computer skills, including navigating multiple systems and keyboarding.
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, and some proprietary applications.
Bilingual ability.
Bachelor’s degree.

Responsibilities

Use clinical tools and information or data review to evaluate members’ needs and benefits.
Apply clinical judgment and strategies to reduce risk factors and barriers and address complex health and social indicators that affect care planning.
Conduct assessments using information from sources such as claims and address conditions, including comorbidities and multiple diagnoses, that affect functionality.
Holistically assess the need for referrals to clinical resources and other interdisciplinary team members.
Collaborate with the supervisor and key stakeholders in members’ healthcare to overcome barriers to goals and objectives.
Present cases at interdisciplinary case conferences.
Use case management processes in compliance with regulatory requirements and company policies and procedures.
Use motivational interviewing to support member engagement and understand health status and needs.