Case Manager RN - Field; Passaic​/Sussex Counties, NJ

Role Overview

Our Integrated Care Management (ICM) Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators that impact care planning.
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presenting cases at interdisciplinary case conferences.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
• Travel 25-50% of the time using personal vehicle to meet members face-to-face; mileage is reimbursed per company policy.
• Remain resident in Passaic or Sussex County, NJ.

• Minimum 3+ years of clinical practice experience.
• Active and unrestricted RN license in the state of NJ.
• Reliable transportation; mileage reimbursed per company policy.
• Effective analytical, problem‑solving, communication, organizational, and interpersonal skills.
• Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint.
• Anticipated weekly hours: 40 hours per week.
• Full‑time, work‑from‑home flexible position with travel to Passaic and Sussex Counties.
• Associate's Degree in Nursing.

• Certified Case Manager.
• Minimum 2+ years of care management, discharge planning, and/or home health care coordination experience.
• Confidence working independently, using tools to collaborate and connect with teams virtually.
• Excellent analytical and problem‑solving skills.
• Proficiency with multiple systems and keyboarding.
• Bilingual.

Pay Range: $66,575.00 – $. The actual base salary will depend on experience, education, geography, and other factors. The position is eligible for a CVS Health bonus, commission, or short‑term incentive program in addition to the base pay range.

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.