Hybrid Case Manager, Registered Nurse

at CVS Health

• Job title: Case Manager, Registered Nurse
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $66,575 - $142,576 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Trenton, United States

About the role

• Case Manager Registered Nurse managing clinical strategies for members in New Jersey communities. Conducting assessments, care plans, and collaborating with diverse populations in a field role.

Responsibilities

• Conduct face-to-face home visits using comprehensive assessment tools for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE).
• Perform in-person assessments for non-MLTSS members to determine medical needs and support appropriate service referrals.
• Successfully complete and maintain NJ Choice Certification (required for continued employment).
• Work with diverse populations, including pediatric and medically complex members.
• Coordinate and collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams.
• Schedule and participate in interdisciplinary meetings, advocating for members to ensure safe transitions and appropriate services.
• Develop individualized care plans and authorize services within MLTSS/FIDE program benefits in a cost-effective manner.
• Document all assessments, interactions, and care planning activities accurately and in a timely manner in the electronic health record.
• Utilize strong critical-thinking and problem-solving skills in daily work.
• Mentor new staff once appropriate proficiency has been achieved.

Requirements

• Active, unrestricted RN license in the state of New Jersey
• Minimum of 3 years of clinical experience in settings such as hospitals, home health, or ambulatory care
• Residency in Middlesex and Mercer County, NJ
• Ability and willingness to travel up to 75% within Middlesex and Mercer Counties.
• Successful completion of NJ Choice Certification, including: Exam score of 80% or higher, Completion of state training modules, Field mentoring, as required by the NJ Division of Aging Services

Benefits

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• 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.