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Skills
Ambulatory Careunmatched
Case Managementunmatched
Certified Case Manager (CCM)unmatched
Clinical Informationunmatched
Communication Skillsunmatched
Compensation and Benefitsunmatched
Computer Skillsunmatched
Corporate Policiesunmatched
Cost Controlunmatched
Establish Prioritiesunmatched
Health Planunmatched
Home Careunmatched
Hospitalunmatched
Maintain Complianceunmatched
Managed Careunmatched
Multitaskingunmatched
Pharmacyunmatched
Presentation/Verbal Skillsunmatched
Quality Managementunmatched
Registered Nurse (RN)unmatched
Regulationsunmatched
Regulatory Complianceunmatched
Retailunmatched
Team Playerunmatched
Willing to Travelunmatched
Writing Skillsunmatched
Description
Our Client, a Retail Pharmacy company, is looking for a Nurse Case Manager II for their Surrounding area of Camden County, NJ (includes Burlington, Atlantic, Gloucester Counties, NJ) location.
Responsibilities:
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.
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
Will be expected to travel to various hospital facilities to meet with members and hospital staff.
Will collaborate with the assigned care manager to report visit findings.
Requirements:
Requires an RN with unrestricted active license
3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
Healthcare and/or managed care industry experience.
Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Requires an RN with unrestricted active license in New Jersey or compact license in good standing and no history.