Location: This role will be work at home with 25-50% travel within Monmouth/Ocean Counties, NJ. (50-mile radius from applicants' home)
Schedule: Standard business hours Monday-Friday 8:00am-5:00pm EST.
Position Summary
The ICM Case Manager develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.
Key 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.
Remote Work Expectations
- This is a remote role with 25-50% travel required, candidates must have a dedicated workspace free of interruptions.
- Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
Required Qualifications
- Minimum 3+ years of clinical practice experience.
- Must have active and unrestricted RN licensure in the state of NJ.
- 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.
- Must reside close to or within Monmouth/Ocean Counties, New Jersey.
Preferred Qualifications
- Certified Case Manager is preferred.
- Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred.
- 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 Preferred.
Educational
- Associate's Degree required.
- Bachelor's degree preferred.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is
$66,575.00 - $142,576.00