Registered Nurse Case Manager - Field in Hudson County NJ - New Hire Bonus

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The Case Manager will develop, implement, and support health service strategies, policies, and programs that ensure high-quality, cost-effective care for our members. These strategies encompass utilization management, quality improvement, network coordination, and clinical policy development. This position requires strong clinical judgment, critical thinking, and the ability to coordinate physical, behavioral, and psychosocial services.Key Responsibilities

• Conduct in-home, face-to-face assessments using comprehensive tools for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE).

• Evaluate non-MLTSS members for service eligibility and support needs, including adult/pediatric medical daycare, personal care assistants, nursing facility services, and MLTSS enrollment.

• Collaborate with members, their representatives, primary care providers, and interdisciplinary care teams to develop and implement individualized care plans.

• Attend and coordinate interdisciplinary team meetings, advocating for members to ensure safe and appropriate service delivery and discharge planning.

• Authorize services within program benefits in a cost-effective manner.

• Accurately and promptly document all activities in the electronic health record.

• Mentor new hires upon achieving proficiency in the role.

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in New Jersey.
• Minimum of 3 years of clinical experience in settings such as hospitals, home health, or ambulatory care.
• Willingness and ability to travel 50-75% within Hudson County and nearby areas.
• Reliable transportation (mileage reimbursed per company policy).
• Successful completion of the NJ Choice Certification, including:

  • A minimum score of 80% on the exam.

  • Completion of state training modules and field mentoring, as required by the NJ Division of Aging Services.

Preferred Qualifications

• Residency in Hudson County.

• Experience in case management or discharge planning.

• Background in managed care, Medicaid/Medicare, or LTSS.

• Proficiency with Microsoft Office Suite (Outlook, Word, Excel, SharePoint, Teams) and multi-system navigation.

Education

• Associate Degree or Diploma in Nursing (minimum requirement).

Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$72,627.00 - $155,538.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 09/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.