Case Manager RN- Burlington & Surrounding Counties
Core
Develop and implement health service strategies, policies, and programs to drive quality healthcare delivery for members in Burlington and surrounding counties, focusing on utilization management, network management, and clinical coverage.
Role type
Senior Case Manager RN (Managed Long-Term Services and Supports)
Builds
Care plans and service authorizations for MLTSS/D-SNP members
Domain
Healthcare / Managed Long-Term Services and Supports (MLTSS)
Deliverable
physical/clinical work
Required skills
Advanced clinical judgment, critical thinking, care planning, direct provider collaboration, resource utilization, assessment, writing, communication, interdisciplinary meeting facilitation, advocacy, documentation, problem solving, mentoring
Preferred skills
Case management, discharge planning, managed care, crisis intervention
Technologies
Electronic health record systems
Responsibilities
Conduct face-to-face home visits for comprehensive assessments; coordinate care with members, authorized representatives, PCPs, and care teams; schedule and attend interdisciplinary meetings; advocate for safe discharge and appropriate services; develop care plans and authorize services within MLTSS/FIDE benefits; document accurately in electronic health records; mentor new hires
Seniority
Mid-Senior level, hands-on IC with mentorship duties
