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