About The Position

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. Field Based RN role in Northern New Jersey-Preference to residents of Essex and Mercer Counties. Position Summary 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.

Requirements

  • Must reside in the State of New Jersey - Would be assigned a case load based on your location.
  • 3+ years’ work experience in pediatric, Special Needs and/or Adult Population
  • BSN RN with current unrestricted state licensure in the State of New Jersey
  • Computer literacy and demonstrated proficiency to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.
  • Highly organized, flexible, and ability to be adaptable and embrace change in a fast-paced environment
  • Ability to critically think and navigate challenging situations
  • Ability to prioritize competing priorities and meet deadlines
  • Self-motivated and dependable
  • Positive, forward-thinking mindset
  • Exceptional communication skills, both verbally and in writing.
  • Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy to complete
  • Requires Face to Face visits in various settings including, but not limited to in homes, hospitals, provider settings, etc. Travel requirements are subject to change based upon business need.

Nice To Haves

  • Case Management experience in an integrated model
  • Bilingual preferred.
  • Working knowledge of medical terminology.
  • Working knowledge of digital literacy skills.
  • Ability to deal tactfully with customers and community.
  • Ability to handle sensitive information ethically and responsibly.
  • CCM (Certified Case Manager)
  • Remote work experience

Responsibilities

  • 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
  • establishing a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers
  • monitoring and evaluating the effectiveness of the care plans and adjust the care plan based on clinical judgement and member needs
  • coordinating and collaborating with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery
  • 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
  • mentor new hires once proficient in the role

Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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