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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.
Position Summary: This is a remote Case Manager opportunity with 50 to 75% field travel in Bergen County and surrounding counties. The working schedule is Monday - Friday 8am-5pm EST.
Job Description:
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 comprise 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.
Fundamental Components/Job Description:
The Case Manager is responsible for conducting face-to-face visits in the member's home utilizing comprehensive assessment tools for members enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Successful completion of company-sponsored NJ Choice Certification is a requirement for continued employment. Member assignment may include pediatric population and medically complex cases. 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 member's 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/FIDE 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. 50 to 75% travel in Bergen County and surrounding counties.
Required Qualifications:
- 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care
- Active and Unrestricted RN license in NJ
- Must reside in Bergen County or an adjacent county
- Willing and able to travel 50 to 75% in Bergen County and surrounding counties of NJ
- Successful completion of the NJ Choice certification is a contingency of employment. An exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.
Preferred Qualifications:
- Case management and/or discharge planning experience
- Managed Care experience
- Crisis intervention skills
Education:
- Minimum of an Associate degree in Nursing
Pay Range:
The typical pay range for this role is: $72,627.36 - $155,538.24. 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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year.
We anticipate the application window for this opening will close on: 12/31/2024.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions.
