Nurse Case Manager II

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. 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.

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.
• Education       
• Case Management Certification CCM preferred

 
Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities