Case Manager Registered Nurse - Field in New Jersey

CVS Health•Field-New Jersey, NJ

1d•$66,575 - $142,576•Hybrid

About The Position

CVS Health is hiring Field Case Manager Registered Nurses to serve members in multiple counties throughout New Jersey. This field-based role involves approximately 75% travel for in-person visits and assessments, with home-based documentation and structured administrative support. The Case Manager evaluates the medical needs of members enrolled in Managed Long-Term Services and Supports (MLTSS), Dual Special Needs Program (D-SNP/FIDE), and other programs, helping members obtain appropriate services and supporting their overall wellness. Assignments may include pediatric and medically complex cases. The role requires coordinating care, advocating for members, supporting safe transitions between care settings, documenting in electronic health records, and mentoring new hires. The position is full time, with 40 anticipated weekly hours. Candidates must reside in New Jersey and meet the stated work-from-home technology and workspace requirements.

Requirements

Must reside in New Jersey.
At least 3 years of clinical nursing experience.
Active, unrestricted Registered Nurse (RN) license in New Jersey.
Reliable transportation and willingness and ability to travel approximately 75% of the time; mileage is reimbursable.
Successful completion of NJ Choice certification is a contingency of employment. This includes a score of at least 80% on the exam, completion of State training modules, and the field-mentoring component.
Minimum associate degree or diploma in nursing.
Must have or obtain a direct, hardwired internet connection to a modem/router within seven feet of the computer, with minimum speeds of 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not acceptable.
Must maintain a quiet, secure, private, organized, and distraction-free home workspace compliant with CVS and HIPAA guidelines, and work within the state and city where currently residing.
Must provide workspace furniture, such as a desk or standing desk, and comply with work-from-home requirements.
Ability to set up and use multiple monitors and navigate multiple applications simultaneously.
Ability to use digital communication channels, including email, calendar invitations, Teams messaging, and virtual meetings.
Ability to use Microsoft Office 365 applications or similar tools.
Ability to access secure systems such as VPN and EHR portals, follow basic security practices, and recognize suspicious emails or links.
Ability to troubleshoot common technical issues independently and contact IT for unresolved issues.
Openness to learning new skills as the workplace environment evolves.

Nice To Haves

Experience with LTSS.
Case management, discharge planning, and/or managed care experience.
Medicaid and Medicare experience.
Experience using computers, keyboards, mice, multi-system navigation, and Microsoft Office applications such as Outlook, Word, Excel, SharePoint, and Teams.

Responsibilities

Conduct face-to-face visits in members’ homes and use comprehensive assessment tools to evaluate medical needs.
Help members obtain appropriate services, including adult or pediatric medical daycare, personal care assistance, nursing-facility custodial services, Personal Preference Program services, and MLTSS enrollment.
Schedule and attend interdisciplinary meetings and advocate for members to support safe discharges with appropriate services in place.
Collaborate with members and the care team to develop care plans and authorize services cost-effectively within the MLTSS/FIDE benefit.
Document accurately and promptly in the member’s electronic health record.
Coordinate and collaborate with members or their authorized representatives, primary care providers, and other care-team participants.
Use critical thinking and problem-solving skills in case management work.
Mentor new hires.