Case Manager RN- Essex County NJ

Job Description
Qualifying candidates are eligible for an up to $7,000 sign on bonus. Candidates holding a NJ Choice Certification are eligible for an up to $10,000 sign on bonus.

This is work from home flexible position with travel requirements.

** This position is eligible for relocation assistance**


Standard Working hours Monday -Friday 8am-5pm

At Aetna Better Health of New Jersey, we believe that our members should have the opportunity to be leaders in their care. Our healthcare professionals are invested in connecting and servicing the Medicaid population in all 21 counties of New Jersey. This is an opportunity to make an impact on the lives of others by getting to know their stories to improve the quality of their lives. The most rewarding aspect of the MLTSS care management role is evidenced by the positive outcomes of collaborative efforts between the care manager, member, and servicing providers.

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.

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). 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 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.

Pay Range
The typical pay range for this role is:
Minimum: 58,760
Maximum: 125,840

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
-Minimum 3 years of clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.

-Active and Unrestricted RN license in NJ required.

-Willing and able to travel 50-75% of their time to meet members face to face in Essex county NJ and surrounding areas/counties.

-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.

COVID Requirements


COVID-19 Vaccination Requirement
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.

Preferred Qualifications
-Case management and/or discharge planning experience preferred.

-Managed Care experience preferred.

-Crisis intervention skills preferred

Education
Associate degree required and bachelor's degree preferred.

Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.