Care Manager RN - Field; Essex County, NJ

Care Manager RN - Field (Essex County, NJ)

Apply for the Care Manager RN - Field (Essex County, NJ) role at CVS Health
.

Location: Work-from-home with 25–50% travel within Essex County, NJ (within a 50‑mile radius of the applicant’s home).

Schedule: Standard business hours Monday–Friday 8:00 am–5:00 pm EST.

Position Summary: The ICM Case Manager develops a proactive plan of care to address identified issues to enhance short- and long-term outcomes and seize opportunities to improve a member’s overall wellness.

Our Mission: Join our Aetna team as an industry leader in serving dual‑eligible populations by utilizing best‑in‑class operating and clinical models. You can have a life‑changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs.

Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in markets across the country. Our Integrated Care Management (ICM) Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conducts assessments that consider information from various sources, such as claims, to address all conditions including co‑morbidity and multiple diagnoses that impact functionality.
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
• Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

• This is a remote role with 25–50% travel required; candidates must have a dedicated workspace free of interruptions.
• Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

• Minimum 3+ years of clinical practice experience.
• Must have active and unrestricted RN licensure in the state of NJ.
• Willing and able to travel 25–50% of their time using their own vehicle to meet members face to face in their assigned area. Reliable transportation required. Mileage is reimbursed per the company expense reimbursement policy.
• Must reside close to or within Essex County, New Jersey.

• Certified Case Manager is preferred.
• Minimum 2+ years of Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred.
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually.
• Excellent analytical and problem‑solving skills.
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently.
• Effective computer skills including navigating multiple systems and keyboarding.
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.
• Bilingual Preferred.

• Associate’s Degree required.
• Bachelor’s degree preferred.

Anticipated Weekly

Hours:

40

Time Type: Full time

Pay Range: $72,627.00 – $ (base hourly or annual salary; actual offer will depend on…