Case Manager RN - Field - Passaic County, NJ at CVS Health

Hillside, New Jersey, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Minimum 3+ years of clinical practice experience
Active and unrestricted RN licensure in the state of NJ
Willing and able to travel 25-50% within Passaic County using own vehicle to meet members face to face; reliable transportation required
Must reside close to or within Passaic County, New Jersey
Preferred Qualifications
Certified Case Manager
Minimum 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 skills

Responsibilities

Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits
Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning
Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality
Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives; presents cases at interdisciplinary case conferences
Utilizes case management processes in compliance with regulatory and company policies and procedures
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation

Skills

Key technologies and capabilities for this role

RNCase ManagementCare PlanningMedicareMedicaidIntegrated Care ManagementPatient AdvocacyHealth Assessment

Questions & Answers

Common questions about this position

Is this a remote position, and what are the travel requirements?

This is a work from home flexible position with 25-50% travel requirements in and around Passaic County, New Jersey within a 50-mile radius from the applicant's home.

What are the standard working hours for this role?

The standard working hours are Monday through Friday from 8 am to 5 pm.

What are the key responsibilities of the Case Manager RN?

The role involves assessing, planning, implementing, and coordinating case management activities, developing proactive care plans, using clinical judgment to reduce risks, conducting holistic assessments, collaborating with stakeholders, and utilizing motivational interviewing skills.

What is the company culture like at CVS Health for this role?

CVS Health emphasizes building a world of health with dedicated, purpose-driven colleagues passionate about transforming health care in a connected, convenient, and compassionate way, focusing on compassionate attention, excellent communication, and collaboration to address members' health and social needs.

What qualifications make a strong candidate for this Case Manager RN position?

Strong candidates will have RN credentials with case management experience, clinical judgment for complex cases, skills in motivational interviewing, holistic assessment abilities, and experience collaborating with interdisciplinary teams for dual eligible Medicare and Medicaid populations.

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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