Case Manager Registered Nurse - Hudson County
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About The Position
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. 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 Hudson County and surrounding counties.
