Case Manager Registered Nurse - Field in Union & surrounding counties, NJ

CVS Health is seeking a Case Manager Registered Nurse to provide field-based case management services for members enrolled in Managed Long-Term Services and Supports (MLTSS) and Dual Special Needs Programs (D-SNP/FIDE) in Union and surrounding counties, New Jersey. This position requires up to 75% field travel to conduct face-to-face home visits, assess member needs, develop care plans, and coordinate services to support member wellness and appropriate resource utilization.

Clinical Setting

This is a field-based role serving members in Union and surrounding counties, NJ. You will conduct home visits to assess members enrolled in MLTSS, D-SNP/FIDE, and non-MLTSS programs. Member assignments may include pediatric populations and medically complex cases.

Responsibilities

• Conduct comprehensive face-to-face assessments in members' homes using standardized assessment tools to evaluate medical needs and facilitate overall wellness
• Address member requests for services including adult medical daycare, pediatric medical daycare, personal care assistance, nursing facility placement, personal preference programs, and MLTSS program enrollment
• Schedule and attend interdisciplinary meetings to advocate for members and ensure safe discharge with appropriate services in place
• Develop care plans in collaboration with members and care teams, authorizing services in a cost-effective manner within MLTSS/FIDE benefits
• Coordinate and collaborate care with members, authorized representatives, primary care physicians, and other care team participants
• Document accurately and timely in the member's electronic health record
• Apply critical thinking and problem-solving skills to address complex member needs
• Mentor new hires once proficiency in the role has been attained

Schedule

Monday through Friday, 8:00 AM to 5:00 PM EST. This is a full-time position with 40 anticipated weekly hours.

Travel Requirements

You must possess reliable transportation and be willing and able to travel 75% of the time in Union and surrounding counties, New Jersey. Mileage is reimbursed per company expense reimbursement policy. You must reside in Union County, NJ.

Required Qualifications

• Active and unrestricted RN license in New Jersey
• Minimum 3 years of clinical practice experience in settings such as hospital, home health, or ambulatory care
• Must reside in Union County, NJ
• Reliable transportation and willingness to travel 75% of the time in Union and surrounding counties
• Successful completion of the NJ Choice certification is a contingency of employment. An exam score of 80% or higher is required, along with successful completion of state training modules and field mentoring component

Education

• Minimum associate's degree or diploma in nursing

Preferred Qualifications

• Long-term services and supports (LTSS) experience
• Case management and/or discharge planning experience
• Managed care experience
• Medicaid and Medicare experience
• Experience using computer, keyboard, mouse, and multi-system navigation
• Proficiency with Microsoft Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)

Work from Home Requirements

If working remotely, you must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer with a minimum download speed of 25 Mbps and 3 Mbps upload. Wi-Fi and satellite internet are not permitted. You must maintain a quiet, secure, and private designated home work location free from distractions, compliant with CVS Health and HIPAA guidelines. You must work within the state and city where you currently reside. The company will provide equipment (keyboard, monitor, computer, headset, etc.); you must provide your own workspace furniture (desk or standing desk).

Technical Requirements

• 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 (Teams, Outlook, Word, Excel, PowerPoint) or similar applications
• Ability to log into secure systems (VPN, EHR portal), lock computer screens when unattended, 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

Compensation and Benefits

The typical pay range for this role is $66,575.00 to $142,576.00 annually. The actual base salary offer will depend on experience, education, geography, and other relevant factors. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to base pay.

This full-time position is eligible for a comprehensive benefits package including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources based on eligibility.

Application Deadline

The application window is anticipated to close on September 30, 2026.