Case Manager RN – Field

Case Manager RN – Field

Requirements

• Minimum 3+ years of clinical practice experience
• Must have active and unrestricted RN licensure in the state of NJ
• Willing and able to travel 25-50% of their time using your own vehicle to meet members face to face in their assigned area. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy. The protection and security of our colleagues is paramount. CVS Health encourages it’s nurses to meet with members in a public place if they feel that is more appropriate. If needed, security escort is also available.
• Must reside in Essex County, New Jersey or within surroundings counties within 50 miles of Essex.

Responsibilities

• Help elevate patient care to a whole new level by serving dual eligible populations
• Utilize best-in-class operating and clinical models
• Collaborate with members, providers, and community organizations to address the full continuum of members’ health care and social determinant needs
• Develop a proactive plan of care to address identified issues to enhance short and long-term outcomes
• Use clinical tools and information/data review to conduct an evaluation of member’s needs and benefits
• Apply clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
• Conduct assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
• Use a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
• Collaborate with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
• Utilize case management processes in compliance with regulatory and company policies and procedures
• Utilize motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Preferred Qualifications

• Certified Case Manager is preferred
• Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
• Bilingual Preferred (English / Spanish)