Case Manager, Registered Nurse - Field
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Job Description
Field RN case manager coordinating assessments, care plans, and services for CVS Health members. Conducting home visits across Union and surrounding New Jersey counties.
Responsibilities:
- Develop, implement, support, and promote health service strategies, tactics, policies, and programs
- Conduct face-to-face visits in members’ homes using comprehensive assessment tools
- Evaluate members’ medical needs and facilitate overall wellness
- Address requests for adult and pediatric medical daycare, personal care assistant services, nursing facility custodial requests, personal preference programs, and MLTSS enrollment
- Manage pediatric and medically complex cases
- Schedule and attend interdisciplinary meetings
- Advocate for members to ensure proper and safe discharge with appropriate services
- Develop care plans with members and care teams
- Authorize services cost-effectively within the MLTSS/FIDE benefit
- Document accurately and timely in members’ electronic health records
- Coordinate and collaborate with members, authorized representatives, PCPs, and other care team participants
- Apply critical thinking and problem-solving skills
- Mentor new hires after attaining proficiency
Requirements:
- Must reside in Union County, New Jersey
- 3+ years clinical practice experience, e.g., hospital setting, home health, or ambulatory care
- Active and Unrestricted RN license in NJ
- Reliable transportation
- Willing and able to travel 50-75% of the time in Hudson and surrounding counties in New Jersey
- Successful completion of the NJ Choice certification, including an exam score of 80% or higher, State training modules, and field mentoring component
- Minimum associate’s degree or diploma in Nursing required
- LTSS experience preferred
- Case management and/or discharge planning experience preferred
- Managed Care experience preferred
- Medicaid and Medicare experience preferred
- Experience using computer, keyboard, mouse, multi-system navigation, and MS Office Suite applications
- Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum 25 Mbps download and 3 Mbps upload
- Wi-Fi and satellite internet are not permitted
- Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines
- Must work within the state and city where currently residing
- Own workspace furniture required
- Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously
- Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings
- Experience with Microsoft Office 365 applications or similar Google Workspace applications
- Ability to log in to secure systems such as VPN and EHR portals, lock computer screens, manage strong passwords, and recognize suspicious emails or links
- Ability to resolve common technical issues independently
- Openness to learning new skills as the workplace evolves
Benefits:
- CVS Health bonus, commission or short-term incentive program in addition to base pay
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- Mileage reimbursement according to company expense reimbursement policy
- Company-provided equipment (keyboard, monitor, computer, headset, etc.)
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