Nurse Case Manager RN - Warren County NJ

Employer
CVS Health
Location
Princeton, New Jersey
Salary
Competitive
Posted
Feb 19, 2021
Closes
Mar 04, 2021
Ref
1471491BR
Contract Type
Permanent
Job Description
Qualifying candidates in the northern regions of New Jersey could be eligible for a sign on bonus of up to $3,000.

Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. The RN Case Manager is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS). The care manager is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant. The RN care manager will attend interdisciplinary meetings and advocate on members behalf. The care manager works with member and care team to develop care plan and will authorize services within the MLTSS benefit. The care manager will also work with the member and care team to coordinate and assist with community resources. The care manager is responsible for documenting accurately and timely in the electronic health record. This position requires the care manager to use critical thinking and be able to problem solve any issues related to assigned membership. While this position is telework the care manager must work normal business hours.

Required Qualifications
3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required
Active and Unrestricted RN license in NJ required
Must be comfortable completing Field based travel to meet with Members; 50- 75% travel required in Warren County and surrounding areas.

Preferred Qualifications
Case management and/or discharge planning experience preferred.
Managed Care experience preferred.
Crisis intervention skills preferred

Education
Associate's degree or equivalent experience

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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