Case Manager Registered Nurse - Bergen County

CVS Health; Ramsey (NJ); Remote; USD 72,000 - 156,000; Full time

Job summary

CVS Health is looking for a Case Manager Registered Nurse in Bergen County, primarily remote with significant field travel requirements. This role involves assessing and planning for patient care across various programs, requiring strong clinical judgment, communication skills, and collaboration with a diverse care team. Candidates should hold an active NJ RN license and have a minimum of 3 years of clinical experience.

Qualifications

• 3+ years clinical practice experience in a healthcare setting.
• Active RN license in NJ.
• Completion of NJ Choice Certification.

Responsibilities

• Develop and implement health service strategies and care plans.
• Conduct face-to-face visits and assessments for members.
• Coordinate care with healthcare providers and manage resources effectively.

Skills

Assessment

Communication

Critical Thinking

Education

Associate degree or Diploma in Nursing

Job description

Case Manager Registered Nurse - Bergen County

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Case Manager Registered Nurse - Bergen County

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This is a remote Case Manager opportunity with 50 to 75% field travel in Bergen County and surrounding counties. The working schedule is Monday - Friday 8am-5pm EST. 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. 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 Bergen County and surrounding counties. Must reside in Bergen County. 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 NJ. Successful completion of the NJ Choice certification is a contingency of employment. Must have OWN transportation. Preferred qualifications include Home Health and/or Hospice Experience, LTSS experience, Case management and/or discharge planning experience, Managed Care experience, Medicaid and Medicare experience, and experience using computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams). Minimum of Associate degree or Diploma in Nursing. 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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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