Registered Nurse Case Manager - Field in Essex and surrounding counties New Jersey

About the role

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Case Manager, Registered Nurse (Field-Based) – Essex and Surrounding Counties, New Jersey. We’re seeking a compassionate and experienced Registered Nurse Case Manager to support members throughout Essex County and nearby areas. This is a remote role with up to 75% field travel, Monday–Friday from 8:00 AM–5:00 PM EST. In this position, you will play a key role in delivering high‑quality, cost‑effective care. You’ll leverage your clinical expertise to develop individualized care plans, coordinate physical, behavioral, and psychosocial services, and ensure members receive the support they need to thrive. We anticipate the application window for this opening will close on 10/31/2026.

Responsibilities

• Conduct in-home, face-to-face assessments for members enrolled in: Managed Long-Term Services and Supports (MLTSS); Dual Special Needs Programs (D-SNP/FIDE)
• Evaluate member needs and coordinate services such as: Adult/pediatric medical day care; Personal care assistant services; Nursing facility placement; MLTSS program enrollment
• Partner with members, caregivers, PCPs, and interdisciplinary teams to develop and implement individualized care plans.
• Authorize services in alignment with program guidelines and support safe transitions of care.
• Document all case activity accurately and promptly in the electronic health record.
• Apply strong clinical judgment and critical thinking to manage complex care needs.
• Mentor new team members once proficiency is achieved.

Requirements

• Active, unrestricted RN license in New Jersey
• Comfort conducting field‑based home visits across all socioeconomic levels and community settings, including any neighborhood or environment, and with members in a wide range of living conditions or circumstances.
• 3+ years of clinical practice experience
• 3+ years of experience in home health, hospice, or a similar setting
• Ability to manage pediatric and medically complex cases
• Residency in Essex County, NJ
• Successful completion of the NJ Choice Certification, including: Minimum exam score of 80%; Completion of state training modules; Field mentoring component
• Minimum of an Associate Degree in nursing
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per company expense reimbursement policy.

Qualifications

Preferred qualifications include:

• Experience with LTSS
• Case management and/or discharge planning background
• Managed care experience
• Familiarity with Medicaid and Medicare
• Proficiency using multiple systems and MS Office Suite (Outlook, Word, Excel, SharePoint, Teams