Registered Nurse Case Manager – Field

CVS Health

. Conduct face-to-face home visits using comprehensive assessment tools for members enrolled in MLTSS and/or D-SNP/FIDE .

Posted 9/29/2026full-timeEast Orange • New 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 individualized care plans for diverse populations, including pediatric and medically complex members. Proficient in case management, crisis intervention, and collaboration with interdisciplinary care teams to ensure effective service delivery.

Highest-signal resume keywords

Active RN License in New JerseyClinical Experience in Hospitals or Home HealthNJ Choice CertificationCase Management ExperienceCrisis Intervention Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Comprehensive Assessment ToolsIndividualized Care PlansElectronic Health Record DocumentationUtilization ManagementQuality ManagementNetwork ManagementClinical Coverage PoliciesService ReferralsInterdisciplinary CollaborationProblem-Solving Skills

Soft Skills

Critical ThinkingMentoringAdvocacy

Certifications & Qualifications

NJ Choice Certification

Industry Keywords

MLTSSD-SNPFIDEManaged CareCrisis InterventionHome VisitsPediatric CareMedically Complex MembersDischarge PlanningField Mentoring

About the role

Key responsibilities & impact

Conduct face-to-face home visits using comprehensive assessment tools for members enrolled in MLTSS and/or D-SNP/FIDE
Perform in-person assessments for non-MLTSS members to determine medical needs and support appropriate service referrals
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 assessments, interactions, and care planning activities accurately and promptly in the electronic health record
Utilize critical-thinking and problem-solving skills in daily work
Mentor new staff after achieving appropriate proficiency
Develop, implement, and support health service strategies, policies, and programs related to utilization management, quality management, network management, and clinical coverage policies
Coordinate physical, behavioral, and psychosocial support services
Work Monday–Friday, 8:00 a.m.–5:00 p.m. EST

Requirements

What you’ll need

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 Essex or adjacent counties
Ability and willingness to travel up to 75% within Ocean and surrounding counties
Successful completion of NJ Choice Certification, including an exam score of 80% or higher
Completion of state training modules
Field mentoring, as required by the NJ Division of Aging Services
Minimum of an associate degree in Nursing
Experience in case management and/or discharge planning preferred
Background in managed care preferred
Crisis intervention skills preferred

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