Remote Hybrid Case Manager RN – NJ

CVS Health

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Field
NJ – Work from home
Full time
Posted Today
R0220703

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

 

 

 

Position Summary

 

This position requires up to 10% travel in the state of NJ.

Shift standard business hours of Monday – Friday 8:00am – 5:00pm; no weekends and no holidays.

Helping members manager their care, and creating care plans to help the member succeed and have a healthier life.

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 Case 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.

 

Job Description:

 

The Case Manager is responsible for conducting face to face visits in the Aetna Better Heath of NJ Medicaid members home utilizing comprehensive assessment tools for members enrolled. 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. 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

Required Qualifications

  • Must reside in the State of New Jersey
  • 3+ years work experience in med surge, pediatric, and/or maternity
  • RN with current unrestricted state licensure in the State of New Jersey
  • Registered Nurse (RN) certification required.
  • Reliable transportation required (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.

 

Preferred

  • 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.

 

Education

  • Bachelors degree or Associates degree in Nursing required

 

 

Pay Range

The typical pay range for this role is:

 

$63,200.80 – $136,600.00

 

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

 

 

 

We anticipate the application window for this opening will close on: 05/31/2024