Registered Nurse Case Manager for CVS Health implementing care strategies in New Jersey. Conducting assessments and coordinating interdisciplinary team meetings for high-quality member care.
Responsibilities
Conduct in-home, face-to-face assessments using comprehensive tools for members enrolled in Managed Long-Term Services and Supports (MLTSS) and/or Dual Special Needs Programs (D-SNP/FIDE)
Evaluate non-MLTSS members for service eligibility and support needs, including adult/pediatric medical daycare, personal care assistants, nursing facility services, and MLTSS enrollment
Collaborate with members, their representatives, primary care providers, and interdisciplinary care teams to develop and implement individualized care plans
Attend and coordinate interdisciplinary team meetings, advocating for members to ensure safe and appropriate service delivery and discharge planning
Authorize services within program benefits in a cost-effective manner
Accurately and promptly document all activities in the electronic health record
Mentor new hires upon achieving proficiency in the role
Requirements
Active, unrestricted Registered Nurse (RN) license in New Jersey
Minimum of 3 years of clinical experience in settings such as hospitals, home health, or ambulatory care
Willingness and ability to travel 50–75% within New Jersey
Must possess reliable transportation and be willing and able to travel up to 75% of the time
Successful completion of the NJ Choice Certification, including: A minimum score of 80% on the exam
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