Case Manager Registered Nurse - Hudson County

CVS Health; Secaucus (NJ); Remote; USD 70,000 - 100,000; Full time

Job summary

CVS Health seeks a Case Manager Registered Nurse in Hudson County for a field role with significant patient interaction. The successful candidate will manage healthcare strategies, collaborate with providers, and ensure quality service delivery, helping members to navigate healthcare services effectively.

Qualifications

• 3+ years clinical practice experience, including home health and ambulatory care.
• Required skills in problem-solving and critical thinking.
• Preferred home health or case management experience.

Responsibilities

• Conduct assessments and care planning for members.
• Collaborate with healthcare providers to manage care effectively.
• Document services and coordinate care in member's electronic health record.

Skills

Assessment Skills

Communication Skills

Critical Thinking

Education

Associate's degree or diploma in Nursing

Active RN license in NJ

Job description

Case Manager Registered Nurse - Hudson County

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Case Manager Registered Nurse - Hudson County

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This is a Field/Remote Case Manager opportunity with 50 to 75% field travel in Hudson 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 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) and 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. Member assignment may include pediatric population and medically complex cases. 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. The case manager is responsible for coordinating and collaborating care with the member/authorized representative, PCP, and any other care team participants. 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. Must reside in Hudson 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. Must possess reliable transportation and be willing and able to travel 50-75% of the time in Hudson and surrounding counties In New Jersey. Mileage is reimbursed per company policy. Successful completion of the NJ Choice certification is a contingency of employment. Preferred qualifications include Home Health and/or Home Hospice Experience, LTSS experience, Case management and/or discharge planning experience, Managed Care experience, Medicaid and Medicare experience, and experience using computer and MS Office Suite applications. Minimum associate’s degree or diploma in Nursing required.

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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