Case Manager Registered Nurse - Field (Monmouth/Ocean Counties,New Jersey)
Core
Develop proactive care plans to enhance short and long-term outcomes and overall wellness for dual eligible members with complex health and social challenges.
Role type
Senior IC case manager registered nurse
Builds
Integrated care management plans for Medicare and Medicaid dual eligible populations
Domain
Healthcare / Social Determinants of Health
Deliverable
client delivery
Required skills
Clinical judgment, motivational interviewing, regulatory compliance, interdisciplinary collaboration, data analysis, care planning
Preferred skills
Certified Case Manager certification, care management/discharge planning experience, bilingualism
Technologies
MS Word, Excel, Outlook, PowerPoint, proprietary care management systems
Responsibilities
Conduct assessments using clinical tools and claims data to evaluate member needs; apply clinical judgment to reduce risk factors and address complex health/social indicators; collaborate with stakeholders and present cases at interdisciplinary conferences; utilize motivational interviewing to ensure member engagement; coordinate case management activities in compliance with policies.
Seniority
Senior, hands-on IC