About the role

Care Manager, Registered Nurse assessing and coordinating the care for members with complex health needs. Collaborating with interdisciplinary teams to enhance members’ overall wellness.

Responsibilities

Help elevate patient care to a whole new level
Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models
Collaborate with members, providers, and community organizations to address the full continuum of members’ healthcare and social determinant needs
Assessing, planning, implementing, and coordinating 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
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
Conduct assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses
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
Utilizes case management processes in compliance with regulatory and company policies and procedures
Utilize motivational interviewing skills to ensure maximum member engagement

Candidate must reside close to or within Camden County, New Jersey
Candidate must have an active and unrestricted Registered Nurse (RN) license in New Jersey
Candidate must be 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. The protection and security of our colleagues is paramount. CVS Health encourages it’s nurses to meet with members in a public place if they feel that is more appropriate. If needed, security escort is also available.)
3+ years of clinical practice experience
Certified Case Manager preferred
2+ years care management, discharge planning and/or home health care coordination experience
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

Affordable medical plan options
401(k) plan (including matching company contributions)
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