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Nurse Case Manager RN – Middlesex County NJ

Aetna Inc.

This is a Full-time position in Princeton, NJ posted February 23, 2021.

Job DescriptionDevelop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psycho social wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes.The RN Case Manager is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS).The RN case manager is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant.The RN case manager will attend interdisciplinary meetings and advocate on members behalf. The care manager works with member and care team to develop care plan and will authorize services within the MLTSS benefit.The case manager will also work with the member and care team to coordinate and assist with community resources.The case manager is responsible for documenting accurately and timely in the electronic health record. This position requires the case manager to use critical thinking and be able to problem solve any issues related to assigned membership. While this position is telework the care manager must work normal business hours.Required Qualifications3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care requiredActive and Unrestricted RN license in NJ required Travel Required – Must be comfortable completing Field based travel to meet with Members; 50 – 75% travel required in Middlesex County NJ and surrounding areas.Preferred QualificationsCase management and/or discharge planning experience preferred Managed Care experience preferred Crisis intervention skills preferredEducationAssociate’s degree or equivalent experienceBusiness OverviewAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.