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RN II, Case Manager

Remote · USA Full-time New today

Job Description:

  • Responsible for performing RN duties using established guidelines to ensure appropriate level of care.
  • Plans for the transition to the continuum of care.
  • Assesses patient's clinical need against established guidelines.
  • Coordinates and assists in implementation of plan for members.
  • Monitors patient's medical care activities and outcomes for appropriateness and effectiveness.
  • Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
  • Serves as mentor/trainer to new RN's and other staff as needed.
  • Represents clinical teams within committee meetings.

Requirements:

  • High School Diploma/GED required.
  • Bachelor degree preferred or relevant experience in lieu of degree.
  • Minimum of two (2) years clinical experience.
  • Minimum of two (2) years’ experience with health care payer experience.
  • Active Unrestricted NJ RN License or active Compact License Required.
  • CCM certification preferred.
  • Must be proficient in the use of personal computers and supporting software in a Windows based environment.
  • Knowledge of hospital structures and payment systems.
  • Understanding of case/care/disease management principles.

Benefits:

  • Comprehensive health benefits (Medical/Dental/Vision)
  • Retirement Plans
  • Generous PTO
  • Incentive Plans
  • Wellness Programs
  • Paid Volunteer Time Off
  • Tuition Reimbursement

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