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RN Field Case Manager

Open 58d
  • In conjunction with the PCP member member’s family and other pertinent members of the Interdisciplinary Care Team (IDT) CM completes a comprehensive assessment and develops a Person Centered Service Care Plan utilizing clinical expertise to evaluate the member’s need for alternative services.
  • Assesses short-term and long-term needs and establishes case management objectives.
  • Manages 75 to 100 active cases based on case intensity and acuity.
  • Responsible for Utilization Management and uses prescribed criteria to provide timely appropriate and medically necessary service authorizations.
  • Interacts continuously with member family physician(s) IDT members and other providers utilizing clinical knowledge and expertise to determine medical history and current status.
  • Must have clear and active RN license in the state of NJ- BSN
  • At least 1 year of care/case management experience
  • Ability to work in a fast paced environment with changing priorities and prioritize workload
  • Ability to create review and interpret treatment plans Ability to create review and interpret treatment plans
  • Ability to implement process improvements
  • Proficient with computers and MS apps

All your information will be kept confidential according to EEO guidelines.

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