Overview At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues — caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.
Position Summary
The care manager is responsible for assessing and evaluating members with potential care management needs through telephonic and face to face assessments in various settings, including the member's private residence, hospitals, behavioral and long-term nursing facilities. The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers. The care manager monitors and evaluates the effectiveness of the care plans and adjusts the care plan based on clinical judgement and member needs. Care managers coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery. The care manager takes an interdisciplinary approach to advocate for member needs to ensure a safe discharge post hospitalization or transition from a nursing facility, including addressing social needs (e.g., housing and food insecurity). Accurate and timely documentation in the member's electronic health record is essential. The care manager role requires critical thinking, problem-solving skills, and the ability to work autonomously. Additionally, the care manager may be asked to mentor new hires once proficient in the role.
Responsibilities Note: The following responsibilities are described within the context of the position as outlined in the job description.
• Assess and evaluate members with potential care management needs across telephonic and in-person settings.
• Develop cost-effective, member-centric care plans in collaboration with members, authorized care givers, and providers.
• Monitor and adjust care plans based on clinical judgment and member needs.
• Coordinate with members, authorized representatives, primary care providers, and other care team participants to ensure timely service delivery.
• Advocate for member needs to support safe hospital discharge or transitions from nursing facilities, including addressing social determinants of health (e.g., housing and food insecurity).
• Maintain accurate and timely documentation in the member's electronic health record.
• Demonstrate critical thinking, problem-solving skills, and ability to work autonomously.
• May mentor new hires once proficient in the role.
Required Qualifications Must reside in the State of New Jersey - Preference to residents of Trenton, Hamilton, Somerset, North Brunswick and East Brunswick.
3+ years' work experience in pediatric, special needs and/or adult population
BSN RN with current unrestricted state licensure in the State of New Jersey
Reliable transportation required to complete face-to-face visits (Mileage is reimbursed per our company expense reimbursement policy)
Computer literacy and demonstrated proficiency navigating internal/external computer systems and MS Office Suite (Word and Excel)
Highly organized, flexible, and able to embrace change in a fast-paced environment
Ability to critically think and navigate challenging situations
Ability to prioritize competing priorities and meet deadlines
Self-motivated and dependable
Positive, forward-thinking mindset
Exceptional communication skills, both verbal and written
Up to 50-75% travel within New Jersey for face-to-face visits in various settings
Preferred Case management experience in an integrated model
Bilingual preferred
Working knowledge of medical terminology
Working knowledge of digital literacy skills
Ability to deal tactfully with customers and community
Ability to handle sensitive information ethically and responsibly
CCM (Certified Case Manager)
Remote work experience
Education BSN Required
Anticipated Weekly Hours 40
Time Type Full time
Pay Range The typical pay range for this role is:
$72,627.00 - $155,538.00
This 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 a variety of factors including experience, education, geography and other relevant 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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Benefits Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 09/30/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.