Nurse Case Manager II

1 week training

The care manager is responsible for assessing and evaluating members with potential care management needs through telephonic and face to face assessments in various settings, including the member s private residence, hospitals, behavioral, and long term nursing facilities. The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers. The care manager monitors and evaluates the effectiveness of the care plans and adjust the care plan based on clinical judgement and member needs. Care managers coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery. The care manager will take an interdisciplinary approach to advocate for member s needs to ensure a safe discharge post hospitalization or transition from a nursing facility, including addressing social needs (e.g., housing and food insecurity). Accurate and timely documentation in the member s electronic health record is essential. The care manager role requires critical thinking, problem-solving skills, and the ability to work autonomously. Additionally, the care manager may be asked to mentor new hires once proficient in the role.

- these should be exp seasoned case workers

***must have candidates county they reside in at the top of their resume: 2 would be for Southern Counties (Ocean, Camden, Burlington, Cumberland, Cape May, Gloucester, Salem)

-Client/Healthcare model experience preferred

- must be list on resume ; RN with current unrestricted state licensure in the State of New Jersey

Position Summary:

see above

Duties:

The care manager is responsible for assessing and evaluating members with potential care management needs through telephonic and face to face assessments in various settings, including the member s private residence, hospitals, behavioral, and long term nursing facilities. The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers. The care manager monitors and evaluates the effectiveness of the care plans and adjust the care plan based on clinical judgement and member needs. Care managers coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery. The care manager will take an interdisciplinary approach to advocate for member s needs to ensure a safe discharge post hospitalization or transition from a nursing facility, including addressing social needs (e.g., housing and food insecurity). Accurate and timely documentation in the member s electronic health record is essential. The care manager role requires critical thinking, problem-solving skills, and the ability to work autonomously. Additionally, the care manager may be asked to mentor new hires once proficient in the role.

Experience:

Required Qualifications

Must reside in the State of New Jersey

3+ years work experience in pediatric, Special Needs and/or Adult Population

RN with current unrestricted state licensure in the State of New Jersey

Registered Nurse (RN) licensure required.

Reliable transportation required to complete F2F visits (Mileage is reimbursed per our company expense reimbursement policy)

Computer literacy and demonstrated proficiency in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.

Highly organized, flexible, and ability to be adaptable and embrace change in a fast paced environment

Ability to critically think and navigate challenging situations

Ability to prioritize competing priorities and meet deadlines

Self-motivated and dependable

Positive, forward thinking mindset

Exceptional communication skills, both verbally and in writing.

This position requires up to 50-75% travel to complete Face to Face visits in the state of NJ in various settings including, but not limited to in homes, hospitals, provider settings, etc. Travel requirements are subject to change based upon business need.

Preferred

Case Management experience in an integrated model.

Bilingual preferred.

Working knowledge of problem solving and decision making skills.

Working knowledge of medical terminology.

Working knowledge of digital literacy skills.

Ability to deal tactfully with customers and community.

Ability to handle sensitive information ethically and responsibly.

CCM (Certified Case Manager)

Remote work experience

Education:

BSN Required with RN licensure required