Case Manager, Registered Nurse - Field

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Develop, implement, support, and promote strategies, tactics, policies, and programs for health services.

• Conduct in-person visits at members’ residences utilizing comprehensive assessment tools.

• Assess members’ medical needs and enhance overall wellness.

• Address inquiries related to adult and pediatric medical daycare, personal care assistant services, nursing facility custodial requests, personal preference programs, and MLTSS enrollment.

• Manage complex pediatric and medically intricate cases.

• Schedule and participate in interdisciplinary meetings.

• Advocate for members to guarantee safe and appropriate discharge with necessary services.

• Collaborate with members and care teams to create care plans.

• Authorize services in a cost-effective manner within the MLTSS/FIDE benefit framework.

• Accurately document information in members’ electronic health records in a timely manner.

• Coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants.

• Employ critical thinking and problem-solving abilities.

• Mentor new hires after achieving a level of proficiency.

⛳️ Requirements

• Must be a resident of Union County, New Jersey.

• A minimum of 3 years of clinical practice experience, such as in a hospital, home health, or ambulatory care setting.

• Possession of an active and unrestricted RN license in New Jersey.

• Access to reliable transportation.

• Willingness and ability to travel 50-75% of the time within Hudson and neighboring counties in New Jersey.

• Successful completion of the NJ Choice certification, including an exam score of 80% or higher, state training modules, and a field mentoring component.

• Minimum of an associate’s degree or diploma in Nursing is required.

• Experience in LTSS is preferred.

• Prior experience in case management and/or discharge planning is preferred.

• Managed Care experience is preferred.

• Familiarity with Medicaid and Medicare is preferred.

• Proficiency in using computers, keyboards, mice, multi-system navigation, and MS Office Suite applications.

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with at least 25 Mbps download and 3 Mbps upload speed.

• Wi-Fi and satellite internet connections are not acceptable.

• A quiet, secure, and private home virtual workspace compliant with CVS Health and HIPAA guidelines is required.

• Must work within the state and city of current residence.

• Ownership of workspace furniture is required.

• Comfortable with setting up and utilizing multiple monitors and navigating various applications simultaneously.

• Ability to communicate effectively via email, calendar invites, Teams messaging, and virtual meetings.

• Experience with Microsoft Office 365 applications or comparable Google Workspace applications.

• Capability to log into secure systems such as VPN and EHR portals, lock computer screens, manage strong passwords, and identify suspicious emails or links.

• Ability to independently resolve common technical issues.

• Willingness to learn new skills as the work environment evolves.

🏝️ Benefits

• Participate in CVS Health bonus, commission, or short-term incentive programs in addition to base salary.

• Comprehensive medical coverage.

• Dental coverage provided.

• Vision coverage included.

• Paid time off available.

• Options for retirement savings.

• Access to wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• Mileage reimbursement in accordance with the company’s expense reimbursement policy.

• Equipment provided by the company (keyboard, monitor, computer, headset, etc.).