Case Manager Registered Nurse - Field Ocean and Surrounding Counties NJ

Position Summary Full‑time field/work at home position requiring up to 75% travel throughout Ocean and surrounding counties in New Jersey. Work hours Monday–Friday, 8:00 a.m.–5:00 p.m. EST. In this role, you will develop, implement, and support health service strategies, policies, and programs that promote high‑quality care for our members. Key Responsibilities Conduct face‑to‑face home visits using comprehensive assessment tools for members enrolled in Managed Long‑Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D‑SNP/FIDE). Perform in‑person assessments for non‑MLTSS members to determine medical needs and support appropriate service referrals (e.g., adult medical daycare, pediatric medical daycare, personal care assistant services, nursing facility custodial care, Personal Preference Program, and MLTSS enrollment). Maintain NJ Choice Certification and related documentation, ensuring continued employment. Work with diverse populations, including pediatric and medically complex members. Coordinate and collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams. Schedule and participate in interdisciplinary meetings, advocating for members to ensure safe transitions and appropriate services. Develop individualized care plans and authorize services within MLTSS/FIDE program benefits in a cost‑effective manner. Document all assessments, interactions, and care planning activities accurately and in a timely manner in the electronic health record. Utilize strong critical‑thinking and problem‑solving skills in daily work. Mentor new staff once appropriate proficiency has been achieved. Required Qualifications Active, unrestricted RN license in the state of New Jersey. Minimum of 3 years of clinical experience in hospitals, home health, or ambulatory care settings. Residency in Ocean County or adjacent counties. Ability and willingness to travel up to 75% within Ocean and surrounding counties. Successful completion of NJ Choice Certification, including an exam score of 80% or higher and completion of state training modules. Field mentoring as required by the NJ Division of Aging Services. Preferred Qualifications Experience in case management and/or discharge planning. Background in managed care. Crisis intervention skills. Education Minimum of an associate degree in Nursing. Anticipated Weekly Hours 40 Time Type Full time Pay Range $66,575.00 - $142,576.00. The pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on experience, education, geography and other factors. This position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range listed above. Benefits This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. Benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. Application Deadline The application window for this opening will close on: 05/31/2026. EEO Statement Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr 4004 Aetna Medicaid Administrators