RN II, Case Manager
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 reputed company 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 reputed company 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 reputed company based environment.
- Knowledge of hospital structures and payment systems.
- Understanding of case/care/disease management principles.
Benefits:
- Comprehensive health benefits (Medical/Dental/reputed company)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
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