Case Manager Registered Nurse - Field (Ocean County, NJ)

Join CVS Health's Aetna Integrated Care Management team as a Case Manager Registered Nurse serving dual eligible populations (Medicare and Medicaid members) in Ocean County, New Jersey. In this field-based role, you will be a frontline advocate for members with complex health and social challenges, conducting comprehensive assessments, developing proactive care plans, and coordinating care across the full continuum of health and social determinant needs.

You will work collaboratively with members, providers, and community organizations to address barriers to care and enhance overall wellness outcomes. This is a work-from-home flexible position with 25-50% travel within a 50-mile radius of your home in Ocean County, NJ.

Responsibilities

• Assess, plan, implement, and coordinate all case management activities with members to evaluate medical needs and facilitate overall wellness
• Use clinical tools and information/data review to conduct comprehensive evaluations of member needs and benefits
• Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators impacting care planning
• Conduct assessments considering information from various sources such as claims to address all conditions including co-morbid and multiple diagnoses that impact functionality
• Use a holistic approach to assess the need for referrals to clinical resources and other interdisciplinary team members
• Collaborate with supervisors and key stakeholders in members' healthcare to overcome barriers in meeting goals and objectives
• Present cases at interdisciplinary case conferences
• Utilize case management processes in compliance with regulatory and company policies and procedures
• Apply motivational interviewing skills to ensure maximum member engagement and discern health status and health needs

Schedule

• Monday through Friday, 8:00 AM to 5:00 PM
• 40 hours per week
• Full-time position

Travel Requirements

• 25-50% travel required using your own vehicle to meet members face-to-face in your assigned area
• Travel within a 50-mile radius of your home
• Reliable transportation required
• Mileage reimbursed per company expense reimbursement policy
• Must reside in Ocean County or surrounding counties in New Jersey

Required Qualifications

• Minimum 3 years of clinical practice experience
• Active and unrestricted RN license in the state of New Jersey
• Willing and able to travel 25-50% of the time using your own vehicle to meet members face-to-face
• Reliable transportation required
• Must reside in Ocean County or surrounding counties, NJ

Preferred Qualifications

• Certified Case Manager (CCM)
• Minimum 2 years of care management, discharge planning, and/or home health care coordination experience
• Confidence working from home and as an independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communication, organizational, and interpersonal skills
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Proficiency with standard corporate software applications including MS Word, Excel, Outlook, and PowerPoint, as well as proprietary applications
• Bilingual capability

Education

• Associate's Degree in Nursing (required)
• Bachelor's Degree (preferred)

Compensation and Benefits

• Pay range: $66,575.00 - $142,576.00 annually
• Eligible for CVS Health bonus, commission, or short-term incentive program in addition to base pay
• Comprehensive benefits package including medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Additional resources based on eligibility

Additional Information

CVS Health prioritizes the protection and security of colleagues. You are encouraged to meet with members in a public place if you feel that is more appropriate. Security escort is available if needed.