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Case Manager Registered Nurse - Field (Middlesex County, New Jersey)
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What they do
A Nurse Case Manager applies nursing expertise to coordinate a patient's medical care and provides advocacy to help them get the best and most affordable care. Develop care plans including discharge planning, coordinate delivery among providers, and teach patients and families how to follow the plan. They may also help patients navigate insurance and other healthcare bureaucracies and access related social services. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment.
$84,150 / year median in New Jersey
+1% projected growth
Job Description
Location:
This role will be work at home with 25-50% travel within Middlesex County , New Jersey. (50-mile radius from applicants' home)Schedule:
Standard business hours Monday-Friday 8:00am-5:00pm EST. Position Summary The ICM Case Manager develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness. Our Mission Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have a life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in markets across the country. Our Integrated Care Management (ICM) Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Help us elevate our patient care to a whole new level! Key Responsibilities Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits. Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning. Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality. Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members. Collaborates 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. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Remote Work Expectations This is a remote role with 25-50% travel required, candidates must have a dedicated workspace free of interruptions. Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Required Qualifications 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 close to or within Middlesex County, New Jersey. 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. NJC Certification preferred but not required Educational Associate's Degree required. Bachelor's degree preferred. Work fromHome Requirements:
- You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
- A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
- Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
- The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
- If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.