Case Manager Registered Nurse - Field in Burlington County NJ

CVS Health•Lumberton, NJ

1d•Hybrid

About The Position

CVS Health is building a world of health around every individual, aiming to shape a more connected, convenient, and compassionate health experience. The company is committed to simplifying health care one person, one family, and one community at a time. This position is for a compassionate and experienced Registered Nurse Case Manager to support members throughout Burlington and Camden Counties, and surrounding counties in New Jersey. It is a remote role that involves up to 75% field travel, with working hours from Monday to Friday, 8:00 AM to 5:00 PM EST. The role is crucial in delivering 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 Burlington County NJ.
Successful completion of the NJ Choice Certification, including: Minimum exam score of 80%, completion of state training modules, and 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.