Case Manager Registered Nurse - Union County

Job title: Case Manager Registered Nurse - Union County in Elizabeth, NJ at CVS Health Company: CVS Health Job description: 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.Position SummarySigning bonus potential up to $17,500 for candidates who possess valid/current NJ Choice Certification or $7,500 for all other eligible external candidates.This is a remote Case Manager opportunity with 50 to 75% field travel in Union 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 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.Fundamental Components/Job Description: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 Union County and surrounding counties.Required QualificationsMust reside in Union County3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory careActive and Unrestricted RN license in NJMust possess reliable transportation and be willing and able to travel up to 50-75% of the time in the Union County NJ area. Mileage is reimbursed per our company expense reimbursement policySuccessful 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.Are you a licensed registered nurse who is passionate about making a difference? CVS Health is seeking dedicated professionals to provide comprehensive care coordination and support to members in the Union County New Jersey area.Key Responsibilities:Coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members.Develops strategy to address issues to outcomes and opportunities to enhance member's overall wellness through integration.Instructs programs and procedures in compliance with network management and clinical coverage policies.· Coordinates all case management activities with members to evaluate medical needs and to facilitate the overall wellness of members.· Develops strategy to address issues to outcomes and opportunities to enhance member's overall wellness through integration.· Instructs programs and procedures in compliance with network management and clinical coverage policies.Required Qualifications:· Must reside in Union County· 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care· Associate degree with Active and Unrestricted RN license in the State of New Jersey· Must possess reliable transportation and be willing and able to travel up to 50-75% of the time in the Union County NJ area. Mileage is reimbursed per our company expense reimbursement policy· 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· LTSS experience· Case management and/or discharge planning experience· Managed Care experience· Medicaid and Medicare experience· Experience using computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)If you’re ready to bring your heart to every moment of health, apply now and be part of a team that’s transforming healthcare.Education

• Minimum of Associate degree or Diploma in Nursing

Anticipated Weekly Hours 40Time Type Full timePay RangeThe typical pay range for this role is:$72,627.00 - $155,538.00This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: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.For more information, visitWe anticipate the application window for this opening will close on: 05/09/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution. Expected salary: $72627 - 155538 per year Location: Elizabeth, NJ Apply for the job now! Apply for this job