Case Manager Registered Nurse - Field in Hudson & surrounding Counties, New Jersey
Core
Conduct face-to-face home visits to assess medical needs of members enrolled in Managed Long-Term Services and Supports (MLTSS) and Dual Special Needs Programs, developing care plans and authorizing services to facilitate wellness and obtain necessary support.
Role type
Field Case Manager Registered Nurse
Builds
Care plans and service authorizations for MLTSS/D-SNP members
Domain
Healthcare / Long-Term Services and Supports (LTSS)
Deliverable
physical/clinical work
Required skills
Advanced clinical judgment, critical thinking, care planning, interdisciplinary collaboration, cost-effective resource utilization, accurate documentation, problem-solving
Preferred skills
LTSS experience, case management/discharge planning experience, managed care experience, Medicaid/Medicare experience
Technologies
Electronic Health Records (EHR), Microsoft Office Suite (Outlook, Word, Excel, SharePoint, Teams), VPN
Responsibilities
Conduct comprehensive home assessments for members with pediatric or medically complex cases; schedule and attend interdisciplinary meetings to advocate for safe discharge; coordinate care with PCPs and care team participants; mentor new hires
Seniority
Mid-level, hands-on IC