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Job Information

CVS Health Case Manager Register Nurse (RN) in Monroe, New Jersey

Job Description

Position open to candidates in Camden County NJ or Gloucester County NJ

Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the

delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies,

policies, and programs are comprised of utilization management, quality management, network management

and clinical coverage and policies. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate

member physical health and behavioral healthcare through assessment and care planning, direct provider

coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of

available resources and optimal, cost-effective outcomes.

Fundamental Components

The RN Case Manager is responsible for conducting face to face visits using comprehensive assessments of members

enrolled in Managed Long-Term Services and Supports program (MLTSS). The care manager is responsible to

coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant.

The RN care manager will attend interdisciplinary meetings and advocate on members behalf. The care manager works

with member and care team to develop care plan and will authorize services within the MLTSS benefit. The care

manager will also work with the member and care team to coordinate and assist with community resources. The care

manager is responsible for documenting accurately and timely in the electronic health record. This position requires

the care manager to use critical thinking and be able to problem solve any issues related to assigned membership.

While this position is telework the care manager must work normal business hours.

Background Experience

3+ years 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

Must be comfortable completing Field based travel to meet with Members; 50 - 75% travel required

Case management and/or discharge planning experience preferred

Managed Care experience preferred

Crisis intervention skills preferred

Additional Job Information

Typical office working environment with productivity and quality expectations Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written.

Education

Associate's degree or equivalent experience

Percent of Travel Required

50 - 75%

Business Overview

Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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