Case Manager Registered Nurse - Field

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose‑driven colleagues — caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.

And we do it all with heart, each and every day.

We are seeking a dedicated Case Manager (RN) to join our team, serving members in New Jersey
. This role involves 50-75% field travel and follows a Monday‑Friday, 8:00 AM‑5:00 PM EST schedule. 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.

• 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.

• 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 New Jersey
  .
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement 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.

• Proficient in Multisystem Navigation:
  Comfortable using multiple monitors and systems simultaneously to streamline tasks and improve efficiency.
• Effective Multitasker:
  Skilled at talking and typing concurrently while managing various responsibilities with focus and accuracy.
• Basic Technical Troubleshooting:
  Able to set up and connect essential hardware (monitors, keyboards, etc.) and resolve common technical issues independently.
• Digital Collaboration & Documentation:
  Experienced in electronic documentation and virtual collaboration tools to support remote teamwork and communication.
• Highly Organized & Results‑Oriented:
  Maintains a structured approach to work, ensuring tasks are completed on time and in alignment with performance metrics.
• Metric‑Driven Performance:
  Demonstrates accountability by consistently meeting or exceeding established goals and expectations.
• Clean & Efficient Workspace Management:
  Keeps work spaces tidy and organized to support productivity and comply with professional standards.

• Experience in case management or discharge planning
  .
• Background in managed care
  , Medicaid/Medicare
  , or LTSS
  .

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

Anticipated Weekly Hours 40

Time Type Full time

Pay Range

The typical pay range for this role is:

$72,627.00 - $
This pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within…