Registered Nurse Case Manager – LTSS

Job not on LinkedIn

🕒 May 19

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $66.6k - $142.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Conduct in-home, face-to-face assessments for members enrolled in: • Managed Long-Term Services and Supports (MLTSS) • Dual Special Needs Programs (D-SNP/FIDE) • Evaluate member needs and coordinate services such as: • Adult/pediatric medical day care • Personal care assistant services • Nursing facility placement • MLTSS program enrollment • Partner with members, caregivers, PCPs, and interdisciplinary teams to develop and implement individualized care plans. • Authorize services in alignment with program guidelines and support safe transitions of care. • Document all case activity accurately and promptly in the electronic health record. • Apply strong clinical judgment and critical thinking to manage complex care needs. • Mentor new team members once proficiency is achieved.

🎯 Requirements

• Active, unrestricted RN license in New Jersey • 3+ years of clinical practice experience • 3+ years of experience in home health, hospice, or a similar setting • Ability to manage pediatric and medically complex cases • Residency in Passaic County NJ • Successful completion of the NJ Choice Certification, including: • o Minimum exam score of 80% • o Completion of state training modules • o Field mentoring component • Must possess reliable transportation and be willing and able to travel up to 75% of the time.

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs