Nurse Case Manager

Here are the job details for your review: Job Title: Nurse Case Manager Duration: 4 + Months Location: North Jersey Pay Rate: $44.12/hr on W2 Shifts: M-F 8am-5pm Field and Telephonic Based Add city/state, zip and county at the top of the resume PREFERRED: if candidates are located in North Jersey (Counties can include: Sussex, Warren, Bergen, Essex, Passaic, Hudson etc.) The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures Position Summary: The Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with an unrestricted active license in NJ (compact licensure). Duties • Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. • Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits. • Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Experience • 3 years of clinical practice experience required (e.g., hospital setting, alternative care setting such as home health or ambulatory care). • Healthcare and/or managed care industry experience required. • Case management experience preferred. • Proficiency with computer skills, including navigating multiple systems and keyboarding. • Effective communication skills, both verbal and written. • Ability to multitask, prioritize, and adapt effectively to a fast-paced, changing environment. • Sedentary work involving extended periods of sitting, talking, and listening. • Ability to work on the telephone and computer for extended periods. • Ability to perform close inspection of handwritten and computer-generated documents, as well as PC monitors. • Typical office working environment with productivity and quality expectations. Education • Requires an RN with an unrestricted active license (no history) in NJ (compact licensure). • Case Management Certification (CCM) preferred. Pay: $43.00 - $44.12 per hour Application Question(s): • Are you currently located in North Jersey (counties may include Sussex, Warren, Bergen, Essex, Passaic, Hudson, etc.)? Experience: • Case management: 3 years (Required) License/Certification: • RN License (Required) Willingness to travel: • 75% (Required) Work Location: In person