Nurse Case Manager

Here are the job details for your review:

Job Title: Nurse Case Manager
Duration: 4 + Months
Location: North Jersey
Pay Rate: $44.12/hr on W2
Shifts: M-F 8am-5pm

Field and Telephonic Based

Add city/state, zip and county at the top of the resume

PREFERRED: if candidates are located in North Jersey (Counties can include: Sussex, Warren, Bergen, Essex, Passaic, Hudson etc.)

The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Position Summary:

The Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Requires an RN with an unrestricted active license in NJ (compact licensure).

Duties
• Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
• Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Experience
• 3 years of clinical practice experience required (e.g., hospital setting, alternative care setting such as home health or ambulatory care).
• Healthcare and/or managed care industry experience required.
• Case management experience preferred.
• Proficiency with computer skills, including navigating multiple systems and keyboarding.
• Effective communication skills, both verbal and written.
• Ability to multitask, prioritize, and adapt effectively to a fast-paced, changing environment.
• Sedentary work involving extended periods of sitting, talking, and listening.
• Ability to work on the telephone and computer for extended periods.
• Ability to perform close inspection of handwritten and computer-generated documents, as well as PC monitors.
• Typical office working environment with productivity and quality expectations.

Education
• Requires an RN with an unrestricted active license (no history) in NJ (compact licensure).
• Case Management Certification (CCM) preferred.

Pay: $43.00 - $44.12 per hour

Application Question(s):
• Are you currently located in North Jersey (counties may include Sussex, Warren, Bergen, Essex, Passaic, Hudson, etc.)?

Experience:
• Case management: 3 years (Required)

License/Certification:
• RN License (Required)

Willingness to travel:
• 75% (Required)

Work Location: In person