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An established industry player is seeking a dedicated Case Manager Registered Nurse to join their innovative team. This role involves assessing and managing care for members in need, ensuring they receive the support necessary for a successful discharge from healthcare facilities. With a focus on collaboration, critical thinking, and compassionate care, this position offers the chance to make a meaningful impact in the lives of individuals. Ideal candidates will thrive in a dynamic environment and possess the skills to navigate complex healthcare needs while advocating for their members. Join a team that values your contributions and fosters a supportive workplace culture.
At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
This Case Manager Registered Nurse position is with Aetna's Long-Term Services and Supports (LTSS) team and is a field-based position out of the Northern and upper Central Region of New Jersey, preferably Middlesex, Bergan or Essex County. The requirements is for candidates to hold an NJ Registered Nurse License, and travel 50-75% of the time to meet with members face to face.
The care manager is responsible for 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.
The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers. The care manager monitors and evaluates the effectiveness of the care plans and adjust the care plan based on clinical judgement and member needs. Care managers coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery. The care manager will take 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). Accurate and timely documentation in the member's electronic health record is essential. The care manager role requires critical thinking, problem-solving skills, and the ability to work autonomously. Additionally, the care manager may be asked to mentor new hires once proficient in the role.
Required Qualifications