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Aetna is now a CVS Health Company

Case Manager RN- Mercer or Ocean County

Primary Location: Princeton, NJ
Additional Locations: NJ-Mercer County, NJ-Ocean County, NJ-Princeton
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Description:
Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.

Fundamental Components:
The Case Manager RN is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS). The Case Manager RN is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant. The Case Manager RN will attend interdisciplinary meetings and advocate on members behalf. The Case Manager RN works with member and care team to develop care plan and will authorize services within the MLTSS benefit. The Case Manager RN will also work with the member and care team to coordinate and assist with community resources. The Case Manager RN is responsible for documenting accurately and timely in the electronic health record. This position requires the care 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.

Background Experience:
3+ years clinical practice experience, e.g., hospital setting, alternative care setting such as home
health or ambulatory care,. ; Required
Active and Unrestricted RN in NJ ; Required
Case management or discharge planning experience or home health experience; Required
Managed Care experience; Preferred
Crisis intervention skills; Preferred
Field based Travel to meet with Members; Required


Education:
Nursing - Registered Nurse

Percent of Travel Required:
50 - 75%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Click To Review Our Benefits (PDF)

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