Case Manager Registered Nurse (Field – Must reside in Somerset County New Jersey)

CVS Health; Bernardsville (NJ); On-site; USD 72,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Case Manager Registered Nurse to join their team in Somerset County, NJ. This field-based position involves developing health service strategies and requires strong clinical judgment and communication skills. The successful candidate will work closely with patients, their families, and care teams to ensure quality healthcare delivery and continuous improvement in service provision.

Benefits

Mileage reimbursement

Qualifications

• Active and Unrestricted RN license in NJ.
• 3+ years clinical practice experience in hospital or home health.
• Preferred experience in case management or discharge planning.

Responsibilities

• Develop and implement healthcare service strategies for members.
• Conduct face-to-face assessments and collaborate with care teams.
• Coordinate care plans and document accurately in electronic health records.

Skills

Assessment

Critical Thinking

Communication

Education

Associate degree or Diploma in Nursing

Job description

Case Manager Registered Nurse (Field – Must reside in Somerset County New Jersey)

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Case Manager Registered Nurse (Field – Must reside in Somerset County New Jersey)

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Join to apply for the Case Manager Registered Nurse (Field – Must reside in Somerset County New Jersey) role at CVS Health

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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 Somerset County New Jersey. The requirements is for candidates to hold a New Jersey Registered Nurse License, and travel 50-75% of the time to meet with members face to face. 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 Somerset County and surrounding counties. Must reside in Somerset County New Jersey. Must possess reliable transportation and be willing and able to travel up to 50-75% of the time within Somerset County and surrounding counties. Mileage is reimbursed per our company expense reimbursement policy. 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. 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 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 required. 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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