Case Manager Registered Nurse - Field in New Jersey at CVS Health

Aberdeen Twp, New Jersey, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

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
Successful completion of the NJ Choice Certification, including a minimum score of 80% on the exam, completion of state training modules, and field mentoring as required by the NJ Division of Aging Services
Associate Degree or Diploma in Nursing (minimum requirement)
Proficient in multisystem navigation, using multiple monitors and systems simultaneously
Effective multitasker, skilled at talking and typing concurrently while managing responsibilities with focus and accuracy
Basic technical troubleshooting: able to set up and connect essential hardware and resolve common technical issues independently
Experienced in electronic documentation and virtual collaboration tools
Highly organized, results-oriented, metric-driven, with a clean and efficient workspace

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
Develop, implement, and support health service strategies, policies, and programs that ensure high-quality, cost-effective care, encompassing utilization management, quality improvement, network coordination, and clinical policy development

Skills

Case Management

Utilization Management

Care Planning

Interdisciplinary Collaboration

MLTSS

D-SNP

In-Home Assessments

Clinical Judgment

Critical Thinking

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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