Case Manager Registered Nurse - Field (Monmouth/Ocean) County, NJ

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

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.
• Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy.
• Must reside close to or within (Monmouth/Ocean ) County, New Jersey.

Required Qualifications

• Minimum 3+ years of clinical practice experience.
• 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.

Preferred Qualifications

• 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.

Education

• Associate's Degree required.
• Bachelor's degree preferred.

Pay Range

The Typical Pay Range For This Role Is $66,575.00 - $142,576.00

Additional Information

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.