Full-Time

Case Manager Registered Nurse

Multiple Teams

Posted on 9/9/2025

Deadline 9/30/25
CVS Health

CVS Health

10,001+ employees

Healthcare, insurance, PBM, and retail pharmacy

Compensation Overview

$72.6k - $155.5k/yr

+ Bonus + Commission + Short-term Incentive Program

Company Historically Provides H1B Sponsorship

Atlantic City, NJ, USA + 1 more

More locations: Shrewsbury, NJ, USA

Hybrid

Candidates must reside in Southern and lower Central Region of New Jersey; preference for Ocean or Atlantic County.

Category
Medical, Clinical & Veterinary (1)
Required Skills
Word/Pages/Docs
Excel/Numbers/Sheets
Requirements
  • Must reside in Southern and lower Central Region of New Jersey; Preference to candidates who reside in Ocean or Atlantic County
  • 3+ years’ work experience in Pediatric, Special Needs and/or Adult Population
  • 2+ years experience managing populations with mental health and/or substance use disorders
  • RN with current unrestricted state licensure in the State of New Jersey
  • Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet with members face to face. Mileage is reimbursed per our company expense reimbursement policy
  • Computer literacy and demonstrated proficiency in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.
Responsibilities
  • 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.
  • Establishing a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers.
  • Monitoring and evaluating the effectiveness of the care plans and adjusting the care plan based on clinical judgement and member needs.
  • Coordinating and collaborating with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery.
  • Taking an interdisciplinary approach to advocate for member’s needs to ensure a safe discharge post hospitalization or transition from a nursing facility, including addressing social needs (e.g., housing and food insecurity).
  • Ensuring accurate and timely documentation in the member’s electronic health record.
  • Utilizing critical thinking, problem-solving skills, and the ability to work autonomously.
  • Mentoring new hires once proficient in the role.
Desired Qualifications
  • Certified Case Manager Certification
  • Case Management experience in an integrated model.
  • Bilingual preferred.
  • Effective communication skills, both verbal and written.
  • Working knowledge of problem solving and decision-making skills.
  • 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.

CVS Health operates as a diversified health services company in the United States, organized into Health Care Benefits, Pharmacy & Consumer Wellness, and Health Services. Its offerings include medical insurance products, retail and mail-order prescription drugs, and pharmacy benefit management (PBM) services, all connected through its integrated platform. By combining insurance, retail pharmacy, PBM, and health solutions, CVS Health coordinates care and controls costs across touchpoints for individuals, employers, and government programs. The company aims to lower health care costs while improving access and health outcomes for customers.

Company Size

10,001+

Company Stage

IPO

Headquarters

Woonsocket, Rhode Island

Founded

1963

Simplify Jobs

Simplify's Take

What believers are saying

  • Aetna drove Q1 2026 operating income to $3 billion, raising EPS guidance to $7.30-$7.50.
  • Health100 AI platform with Google Cloud enhances personalized care and efficiency.
  • Pharmacy-only stores expand to 20 sites in 2026, targeting underserved Chicago, Houston areas.

What critics are saying

  • Aetna pays $117.7M DOJ settlement for Medicare Advantage diagnosis fraud in May 2026.
  • FTC insulin settlement forces Caremark rebate transparency, compressing PBM margins by 2027.
  • Walgreens VillageMD and Walmart clinics erode CVS retail pharmacy market share in 2026.

What makes CVS Health unique

  • CVS Health integrates Aetna insurance, Caremark PBM, and 9,000 retail pharmacies into closed-loop care.
  • Specialty units like Accordant and Coram serve 45,000 patients monthly for complex conditions.
  • HealthHub kiosks and MinuteClinics pilot preventive care in Atlanta, Houston, Philadelphia.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Company News

PR Newswire
Mar 30th, 2026
CVS opens first pharmacy-only location in Chicago, plans nearly 20 this year

CVS Health has opened its first pharmacy-only location in Chicago, part of plans to launch nearly 20 such sites across the US this year. The 3,000-square-foot store at 2628 West Pershing Road features a full-service pharmacy with selected over-the-counter products. The pharmacy-only format is designed to increase access to medications, immunizations and pharmacist consultations in underserved communities. Additional locations are planned for Houston, Roxbury, Detroit and Brooklyn in 2026, alongside more than 40 traditional CVS Pharmacy stores. The move responds to consumer preferences, with CVS's 2025 research showing 80% of patients prefer face-to-face pharmacy care and 48% would switch pharmacies if limited to digital-only options. The company opened its first pharmacy-only site in Birmingham, Alabama, late last year.

Yahoo Finance
Mar 26th, 2026
CVS settles FTC insulin pricing probe as regulatory scrutiny of pharmacy benefit manager intensifies

CVS Health has reached a proposed settlement with the Federal Trade Commission over insulin pricing practices at its Caremark pharmacy benefit manager unit. The company also declared a quarterly dividend of $0.665 per share, payable on 4 May 2026. The settlement places CVS's pharmacy benefit management model under increased regulatory scrutiny regarding drug cost transparency. The company's investment narrative centres on its integrated model across insurance, pharmacy and care delivery, with near-term focus on restoring profitability in healthcare delivery and PBM services. CVS recently appointed former Elevance Health CFO John E. Gallina to its board as an audit committee financial expert. The company's narrative projects $445.5 billion revenue and $10.2 billion earnings by 2029, implying a fair value of $96.50 per share.

Yahoo Finance
Mar 23rd, 2026
Bernstein upgrades CVS Health to Outperform with $94 price target amid Medicare Advantage turnaround

Bernstein analyst Lance Wilkes upgraded CVS Health to "Outperform" from "Market Perform" on 12 March, raising the price target to $94 from $91. The upgrade reflects the company's attractive exposure to the Medicare Advantage turnaround and expectations of stable earnings in its pharmacy and pharmacy benefit manager businesses following reforms. Wilkes cited the PBM bill passage and the Federal Trade Commission settlement with Cigna as clearing events for the stock. Separately, CVS Health announced a strategic partnership with Google Cloud focused on reimagining healthcare experiences through its new health technology subsidiary, Health100, which will offer AI-powered healthcare services. CVS Health operates as a diversified healthcare company combining insurance, pharmacy benefit management, retail pharmacies and clinical services across the United States.

Yahoo Finance
Mar 13th, 2026
CVS Health's Aetna unit pays $117.7M to settle Medicare Advantage fraud allegations

Aetna, a CVS Health subsidiary, has agreed to pay $117.7 million to the US Department of Justice to settle allegations that it submitted inaccurate diagnosis codes for Medicare Advantage members to increase reimbursements. The settlement resolves longstanding False Claims Act allegations related to the Medicare Advantage programme. CVS Health shares recently closed at $76.07, down 5.1% year-to-date, though up 20.1% over the past year. The settlement is material for the company, which has thin net margins of 0.4% and debt not well covered by operating cash flow. The agreement highlights compliance risks in CVS Health's government-facing insurance operations, a central part of its Medicare Advantage business. Analysts' average target price stands at $96.50, approximately 27% above current levels.

Yahoo Finance
Mar 7th, 2026
Alphabet faces wrongful death lawsuit over Gemini AI chatbot while expanding healthcare partnership with CVS

Alphabet faces a wrongful death lawsuit alleging its Gemini AI chatbot contributed to a user's suicide, reportedly the first legal case directly linking Google's AI tools to a death. Simultaneously, the company announced a healthcare AI partnership with CVS Health focused on a real-time consumer engagement platform. The contrasting developments underscore Alphabet's expanding role in high-stakes sectors. The CVS collaboration integrates Gemini into Health100, a platform handling personal interactions across insurers, pharmacies and care providers. Meanwhile, the lawsuit tests whether conversational AI design and crisis protocols carry a duty of care, even outside formal healthcare settings. For investors, the key questions centre on how Alphabet manages legal risk, establishes guardrails and navigates regulatory oversight as its AI tools penetrate sectors requiring heightened safety and compliance standards.

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