At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary: Case Manager (Remote - Morris County, NJ)
This is a remote Case Manager role with 50-75% field travel in Morris County and surrounding areas. Standard work hours are Monday-Friday, 8:00 AM-5:00 PM EST.
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The Case Manager is responsible for delivering high-quality, cost-effective care through the development and implementation of health service strategies. This includes utilization management, quality improvement, and coordination of physical, behavioral, and psychosocial services.Key Responsibilities:
- Conduct in-home, face-to-face assessments for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE).
- Evaluate member needs and coordinate services such as adult/pediatric medical daycare, personal care assistance, nursing facility placement, and MLTSS enrollment.
- Collaborate with members, caregivers, primary care providers, and interdisciplinary teams to develop and implement individualized care plans.
- Authorize services within program guidelines and ensure safe, appropriate care transitions.
- Accurately and promptly document all activities in the electronic health record.
- Apply critical thinking and clinical judgment to resolve complex care issues.
- Mentor new hires upon achieving proficiency in the role.
- Active and Unrestricted RN license in NJ
- 3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care
- Strong assessment, communication, and documentation skills.
- Ability to manage pediatric and medically complex cases.
- Successful completion of NJ Choice Certification (80 % or higher required for continued employment).
- Must be able to work independently in a remote setting and travel as needed.
- LTSS experience
- Case management and/or discharge planning experience
- Managed Care experience
- Medicaid and Medicare experience
- Experience using computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)
- Minimum of Associate degree or Diploma in Nursing
40Time Type
Full timePay Range
The typical pay range for this role is:$72,627.00 - $155,538.00This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.