Case Manager, CVS Health

CVS Health

Location:
United States, Hudson County

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

72627.00 - 155538.00 USD / Year

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Job Description:

We are seeking a dedicated Case Manager (RN) to join our team, serving members in Hudson County and surrounding areas. This role involves 50–75% field travel and follows a Monday–Friday, 8:00 AM–5:00 PM EST schedule. The Case Manager will develop, implement, and support health service strategies, policies, and programs that ensure high-quality, cost-effective care for our members. These strategies encompass utilization management, quality improvement, network coordination, and clinical policy development. This position requires strong clinical judgment, critical thinking, and the ability to coordinate physical, behavioral, and psychosocial services.

Job Responsibility:

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
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 Hudson County and nearby areas
reliable transportation
successful completion of the NJ Choice Certification, including a minimum score of 80% on the exam, and completion of state training modules and field mentoring as required by the NJ Division of Aging Services

Nice to have:

Residency in Hudson County
experience in case management or discharge planning
background in managed care, Medicaid/Medicare, or LTSS
proficiency with Microsoft Office Suite (Outlook, Word, Excel, SharePoint, Teams) and multi-system navigation

What we offer:

Affordable medical plan options
401(k) plan including matching company contributions
employee stock purchase plan
no-cost wellness programs including wellness screenings, tobacco cessation programs, 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

Additional Information:

Job Posted:
August 02, 2025

Expiration:
August 31, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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Case Manager