RN Field Case Manager

One of the fastest growing managed care companies in the U.S.

• 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.