Hybrid Case Manager, Registered Nurse

Posted 2 months ago

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About the role

  • Registered Nurse Case Manager for CVS Health implementing care strategies in New Jersey. Conducting assessments and coordinating interdisciplinary team meetings for high-quality member care.

Responsibilities

  • 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

Requirements

  • 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
  • Successful completion of the NJ Choice Certification, including: A minimum score of 80% on the exam
  • Technical skills: Proficient in Multisystem Navigation, Effective Multitasker, Basic Technical Troubleshooting, Digital Collaboration & Documentation, Highly Organized & Results-Oriented, Metric-Driven Performance, Clean & Efficient Workspace Management

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation, and weight management programs
  • Confidential counseling and financial coaching
  • 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

Job title

Case Manager, Registered Nurse

Job type

Experience level

Mid levelSenior

Salary

$72,627 - $155,538 per year

Degree requirement

Associate's Degree

Location requirements

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