Case Manager Registered Nurse - Field in Mercer County NJ

CVS Health • East Orange, NJ

1d • Hybrid

About The Position

CVS Health is building a world of health around every individual, shaping a more connected, convenient, and compassionate health experience. The company seeks a compassionate and experienced Registered Nurse Case Manager to support members throughout Mercer County and surrounding counties. This is a remote role with up to 75% field travel, operating Monday–Friday from 8:00 AM–5:00 PM EST. In this position, the RN Case Manager will deliver high-quality, cost-effective care by leveraging clinical expertise to develop individualized care plans, coordinate physical, behavioral, and psychosocial services, and ensure members receive the necessary support to thrive.

Requirements

• Active, unrestricted RN license in New Jersey.
• Comfort conducting field-based home visits across all socioeconomic levels and community settings, including any neighborhood or environment, and with members in a wide range of living conditions or circumstances.
• 3+ years of clinical practice experience.
• 3+ years of experience in home health, hospice, or a similar setting.
• Ability to manage pediatric and medically complex cases.
• Residency in Mercer County NJ.
• Successful completion of the NJ Choice Certification, including: Minimum exam score of 80%, Completion of state training modules, Field mentoring component.
• Must possess reliable transportation and be willing and able to travel up to 75% of the time.

Nice To Haves

• Experience with LTSS Case management and/or discharge planning background.
• Managed care experience.
• Familiarity with Medicaid and Medicare.
• Proficiency using multiple systems and MS Office Suite (Outlook, Word, Excel, SharePoint, Teams).

Responsibilities

• Conduct in-home, face-to-face assessments for members enrolled in Managed Long-Term Services and Supports (MLTSS) and Dual Special Needs Programs (D-SNP/FIDE).
• Evaluate member needs and coordinate services such as Adult/pediatric medical day care, personal care assistant services, nursing facility placement, and MLTSS program enrollment.
• Partner with members, caregivers, PCPs, and interdisciplinary teams to develop and implement individualized care plans.
• Authorize services in alignment with program guidelines and support safe transitions of care.
• Document all case activity accurately and promptly in the electronic health record.
• Apply strong clinical judgment and critical thinking to manage complex care needs.
• Mentor new team members once proficiency is achieved.

Benefits

• Comprehensive and competitive mix of pay and benefits.
• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.
• CVS Health bonus, commission or short-term incentive program.
• Mileage is reimbursed per our company expense reimbursement policy.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees