Case Manager Rn Assessor (Arn)

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Position Summary
Schedule and conduct in-home comprehensive clinical assessments for potential and current Managed Long Term Care members, creating service plans and determining eligibility. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.
Position Summary/Mission
Assessment RN is responsible for conducting face to face comprehensive assessments on all new potential enrollees, as well as current members, to determine service needs and continued eligibility as outlined by the NYS DOH MAP contract. Coordinates with the Care Management team to maintain a high level of efficient and effective individualized Care Management operations.
The dedication of talented and caring health care professionals drives the delivery of high-quality, cost-effective products and services. They make it possible for members to get the right health care treatment for their needs- and for Aetna to keep its competitive edge. Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
Fundamental Components & Physical Requirements include but are not limited to
Develops, implements, and supports Health Strategies, tactics, polices, and programs that ensure the delivery of benefits to establish overall member wellness

• 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.

• Utilizes clinical skills to assess and document all aspects of the potential member's long-term community-based needs, in compliance with the MAP contract, determining eligibility for potential new members
• Provides community-based training and education for frail population care including self-care techniques and prevention strategies
• Conducts face to face UAS assessments according to state guidelines, policies, procedures, and protocols
• Conducts comprehensive assessment of all aspects of potential new member's condition - clinical, social, and environmental to determine the level of services needed to appropriately keep member safe in the community

• Gathers clinical information from various sources to address all conditions, and follows appropriate guideline, policy, procedure, and clinical judgment in completing assessment requirements
• Communicates with consumers, families, providers, and other parties as needed to complete accurate comprehensive assessment
• Understands the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
• Acts as intermediary between providers and members, serving in numerous roles such as evaluator, educator, and community resource researcher
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives
• Conducts all assessment functions in compliance with regulatory and company policies and procedures

• Communicates and collaborates regularly with Assessment Supervisor and Care Management team

Required Qualifications

• Proficient in use of UAS-NY
• UAS-NY Assessor experience
• UAS-NY Assessor Certification

Preferred Qualifications

• 2 years clinical practice experience
• Minimum 1 year home care, hospice, or field-based case management experience
• MLTC/ MAP/ Managed Care experience preferred
• Bilingual preferred

Education

• Current, unrestricted RN licensure for the state of New York

Additional Information (situational competencies, skills, work location requirements, etc)

• Field based position that requires daily travel throughout the NY-FIDE service area of Brooklyn (Kings County)
• Designated service area will be assigned, but must be flexible to meet the business need
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding, use of online calendars
• Effective communication skills, both verbal and written
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
• Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods of time, talking on the telephone, writing, and typing on the computer.

Pay Range
The typical pay range for this role is:
$60,522.80 - $129,600.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.