Case Manager Registered Nurse - Field - reside in Camden

Position: Case Manager Registered Nurse - Field - Must reside in Camden County New Jersey
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary This is a remote case management opportunity with required travel throughout Camden County NJ and the surrounding county areas.

Job description:

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services.

The care manager will be responsible for; care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. Strong assessment, writing and communication skills are required. Fundamental Components/

Job Description:

The Case Manager is responsible for conducting face to face visits in the members home utilizing comprehensive assessment tools for members enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Care manager may also be responsible for face to face assessments with non-MLTSS members to evaluate the medical needs of the member to facilitate the member's overall wellness and help them obtain the services they need to thrive by addressing requests for services such as adult medical daycare, pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment.

Successful completion of company sponsored NJ Choice Certification is requirement for continued employment. Member assignment may include pediatric population and medically complex cases. The case manager is responsible for coordinating and collaborating care with the member/authorized representative, PCP, and any other care team participants. The case manager schedules and attends interdisciplinary meetings and advocates on the members behalf to ensure proper and safe discharge with appropriate services in place.

The case manager works with the member and care team to develop a care plan and authorizes services in a cost-effective manner within the MLTSS/ FIDE benefit. The care manager is responsible for documenting accurately and timely in the member's electronic health record. This position requires the case manager to use critical thinking skills and the ability to problem solve.

The Case Manager will also be expected to mentor new hires, once, a level of proficiency has been attained in their role. 50 to 75% travel in counties throughout Southern NJ.

Required Qualifications 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care Active and unrestricted RN license in NJMust reside in or near Camden County NJWilling and able to travel 50 to 75% of their time in Camden County and surrounding areas

Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.

Preferred Qualifications Home health experience

Case management and/or discharge planning experience

Managed Care experience

Crisis intervention skills

Experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)NJ Choice Certification Education Minimum of an Associate degree in Nursing or Diploma RN required

Anticipated Weekly Hours
40

Time Type Full time

Pay Range The typical pay range for this role is:$66,575.00 - $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.

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