At Aetna Better Health of New Jersey, we believe that our members should have the opportunity to be leaders in their care. Our healthcare professionals are invested in connecting and servicing the Medicaid population in all 21 counties of New Jersey. This is an opportunity to make an impact on the lives of others by getting to know their stories to improve the quality of their lives. The most rewarding aspect of the MLTSS care management role is evidenced by the positive outcomes of collaborative efforts between the care manager, member, and servicing providers.

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires leadership, advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services. The care management supervisor will be responsible daily program oversight, staff recruitment, staff retention, problem solving, inter and intradepartmental collaboration, direct collaboration with state partners.

The Care Management Supervisor shall be responsible for the management and supervision of the MLTSS Care Management staff. The supervisor is responsible for the daily operations of the MLTSS Program and contractual adherence. The Supervisor will oversee staff who cover CM in Southern NJ and surrounding counties. This includes members enrolled in enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Supervisor's Care manager may also be responsible for face to face assessments with non-MLTSS members to evaluate the medical needs of the member to facilitate the member's overall wellness and help them obtain the services they need to thrive by addressing requests for services such as adult medical daycare, pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment. Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.

Required Qualifications

• 4+ years of experience serving members/patients with special needs in a healthcare setting
• 1+ years of previous leadership experience managing teams and personnel
• Must have one of the following active unrestricted NJ State Licensure RN, LSW, or LCSW
• Willing and able to travel up to 10% of their time using your own vehicle to meet and support staff as needed anywhere in the state of New Jersey; primarily supporting staff in Southern NJ including Atlantic, Cape May, Burlington, Camden, Cumberland, Salem, or Gloucester County.
• Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component
• 1+ years of excellent assessment, writing, and communication skills
• 1+ years' experience using a computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)

Preferred Qualifications

• Strongly prefers candidates residing in Southern NJ including Atlantic, Cape May, Burlington, Camden, Cumberland, Salem, or Gloucester County
• LTSS experience
• Managed Care Organization experience
• Experience working with Medicaid and/or Medicare

Education

• Minimum of Bachelor's degree in Nursing required for RN and Master's degree required for BH

Pay Range

The typical pay range for this role is:

$96,408.00 - $207,648.00

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 Benefits | CVS Health

We anticipate the application window for this opening will close on: 12/31/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.