Case Manager RN - Field (Ocean County, NJ)
About the role
This is a work from home flexible position with 25-50% travel in Ocean County, New Jersey. Travel will be up to a 50 mile radius from your home. Standard working hours are Monday through Friday, 8-5 pm.
Responsibilities
- Assess, plan, implement, and coordinate all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
- Develop 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.
- 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, presenting 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.
Requirements
- Minimum 3+ years of clinical practice experience.
- Active and unrestricted RN license 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.
- Must reside in Ocean or surrounding County, NJ.
Qualifications
- Associate’s Degree in Nursing preferred.
- Bachelor's Degree 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.
- Uses standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.
- Bilingual preferred.
Skills
Not specified
Benefits
The typical pay range for this role is $66,575.00 - $142,576.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Pay
The typical pay range for this role is $66,575.00 - $142,576.00. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Schedule
Standard working hours are Monday through Friday, 8-5 pm.