Case Manager Registered Nurse – Field

CVS Health

. Conduct face-to-face visits in members’ homes using comprehensive assessment tools .

Posted 9/15/2026full-timeNew Jersey • United StatesMid-LevelSenior💰 $66,575 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting comprehensive assessments and developing care plans for members in MLTSS and D-SNP/FIDE programs, while effectively coordinating services and advocating for member needs. Proficient in utilizing electronic health records and managing interdisciplinary collaboration to ensure quality care delivery.

Highest-signal resume keywords

Active RN License In NJ3+ Years Clinical Practice ExperienceNJ Choice CertificationCase Management ExperienceMedicaid And Medicare Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Comprehensive Assessment ToolsCare Plan DevelopmentCritical ThinkingService AuthorizationInterdisciplinary CollaborationHealth Service StrategiesProblem SolvingMulti-System NavigationEHR DocumentationVirtual Meeting Coordination

Soft Skills

AdvocacyMentoringCommunication

Tools & Technologies

Microsoft Office 365Google WorkspaceVPNEHR Portals

Certifications & Qualifications

NJ Choice Certification

Industry Keywords

MLTSSD-SNP/FIDEManaged CareLTSS ExperienceHome HealthAmbulatory CareHIPAA Compliance

About the role

Key responsibilities & impact

Conduct face-to-face visits in members’ homes using comprehensive assessment tools
Evaluate medical needs of members enrolled in MLTSS, D-SNP/FIDE, and non-MLTSS programs
Facilitate members’ overall wellness and help obtain needed services
Address service requests including adult and pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program, and MLTSS enrollment
Develop, implement, support, and promote health service strategies, policies, and programs
Apply advanced clinical judgment and critical thinking to coordinate physical, behavioral health, and psychosocial wrap-around services
Develop care plans with members and care teams
Authorize services cost-effectively within the MLTSS/FIDE benefit
Schedule and attend interdisciplinary meetings
Advocate for members and ensure safe discharge with appropriate services in place
Coordinate and collaborate with members, authorized representatives, PCPs, and other care team participants
Document accurately and timely in members’ electronic health records
Solve problems using critical thinking
Mentor new hires after attaining proficiency

Requirements

What you’ll need

Must reside in Hudson &/or Surrounding Counties in New Jersey
3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care
Active and Unrestricted RN license in NJ
Must possess reliable transportation and be willing and able to travel up to 75% of the time in Hudson and surrounding counties in New Jersey
Successful completion of the NJ Choice certification, including an exam score of 80% or higher, State training modules, and field mentoring component
Minimum associate’s degree or diploma in Nursing required
LTSS experience preferred
Case management and/or discharge planning experience preferred
Managed Care experience preferred
Medicaid and Medicare experience preferred
Experience using computer, keyboard, mouse, multi-system navigation, and MS Office Suite applications
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
Wi-Fi and satellite internet are not permitted
Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently residing
Must provide workspace furniture, such as a desk or standing desk
Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously
Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar applications such as Google Workspace
Ability to log in to secure systems such as VPN and EHR portals, lock computer screens, manage strong passwords, and recognize suspicious emails or links
Ability to resolve common technical issues independently and contact IT for unresolved issues
Openness to learning new skills as the workplace environment evolves

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay
Mileage reimbursement per company expense reimbursement policy
Company-provided equipment (keyboard, monitor, computer, headset, etc.)