Case Manager Registered Nurse - Field Ocean and Counties NJ

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health® you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

This is a full‑time field/work at home position requiring up to 75% travel throughout Ocean and surrounding counties in New Jersey. Work hours are Monday–Friday, 8:00 a.m.–5:00 p.m. EST. In this role, you will develop, implement, and support health service strategies, policies, and programs that promote high‑quality care for our members. These initiatives include utilization management, quality management, network management, and clinical coverage policies.

The position requires advanced clinical judgment, strong critical‑thinking abilities, and the capacity to coordinate physical, behavioral, and psychosocial support services. Responsibilities include care planning, direct collaboration with providers, and effective resource utilization. Strong assessment, written documentation, and communication skills are essential.

• 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 (e.g., adult medical daycare, pediatric medical daycare, personal care assistant services, nursing facility custodial care, Personal Preference Program, and MLTSS enrollment).
• 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.

• 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 Ocean County or adjacent counties.
• Ability and willingness to travel up to 75% within Ocean and surrounding 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

• Experience in case management and/or discharge planning
• Background in managed care
• Crisis intervention skills

• Minimum of an associate degree in Nursing

40

Full time

$66,575.00 - $

We 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

We anticipate the application window for this opening will close on: 03/08/2026

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