Registered Nurse Case Manager - Field in Essex & surrounding Counties, New Jersey
Core
Field Case Manager Registered Nurse developing and implementing health service strategies, care plans, and utilization management for members in Managed Long-Term Services and Supports programs.
Role type
Senior IC Registered Nurse Case Manager
Builds
Care plans and service authorizations for MLTSS/D-SNP members
Domain
Healthcare / Managed Long-Term Services and Supports
Required skills
Advanced clinical judgment, critical thinking, care planning, interdisciplinary collaboration, cost-effective resource utilization, accurate documentation, problem-solving, mentoring
Preferred skills
LTSS experience, case management, discharge planning, managed care, Medicaid/Medicare experience
Technologies
EHR systems, Microsoft Office Suite (Outlook, Word, Excel, SharePoint, Teams), VPN, multi-system navigation
Responsibilities
Conduct face-to-face home visits to assess medical needs and facilitate service enrollment; Schedule and attend interdisciplinary meetings to advocate for safe discharge; Develop care plans and authorize services within benefit limits; Coordinate care with PCPs and care team participants; Document accurately in electronic health records; Mentor new hires
Seniority
Mid-Senior level, hands-on IC