3 Registered Nurse Case Manager-Corporate Managed Care Jobs in Hackensack, NJ
HMH HOSPITALS CORPORATION is Hiring a Registered Nurse Case Manager-Corporate Managed Care Near Hackensack, NJ
Our team members are the heart of what makes us better.
At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.
Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The Nurse Care manager is a member of the healthcare team and is responsible for coordinating, communicating and facilitating the clinical progression of the patient's treatment and discharge plan .He/She is accountable for a designated patient caseload. They asses, plan, and facilitate, with patients/families and healthcare professionals involved in the patients care to meet treatment goals, expected length of stay, and arrange for the appropriate next level of care .Oversees Inter facility Coordination and handoff between acute & post-acute services.
Qualifications:
Education, Knowledge, Skills and Abilities Required:
- Bachelor's degree in nursing (BSN) or 1 year experience for non BSN HackensackUMC employees.
- Knowledge of federal and state regulations (DOH, Medicaid/Medicare)
- Knowledge of third party payers and/or managed care principles.
- Knowledge of guidelines for Medicaid/Medicare and related state programs.
- Knowledge of InterQual/MCG criteria and other guidelines for medical necessity, setting and level of care, and concurrent patient management.
- Knowledge of health care delivery system, utilization and review and case review procedures.
- Good working knowledge of benefit plans; HMO, Medicare, Medicaid, Employee, Commercial, Medicare Advantage, etc.
- Computer skills to include Microsoft Work, Excel, data entry and Utilization Management Software.
- Strong organizational and problem solving skills.
- Excellent oral and written communication and interpersonal skills.
- Exceptional communication skills to enable communication and collaboration with physician, patients, families and ancillary staff.
- Excellent critical thinking skills.
- Ability to work in a fast pace team environment.
- Ability to prioritize and multi-task.
- Ability to make sound, independent clinical judgements and act professionally under pressure.
Education, Knowledge, Skills and Abilities Preferred:
- Three to five years clinical experience.
- Experience with relevant systems; Excel, Word, EPIC, Allscripts, MCG, Sorian
Licenses and Certifications Required:
- NJ State Professional Registered Nurse License.
- AHA Basic Health Care Life Support HCP Certification.
Licenses and Certifications Preferred:
- Certified Case Manager.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!
Job Summary
Full Time
Hospital
$98k-118k (estimate)
02/17/2024
05/12/2024
hackensackumc.org
EDISON, NJ
7,500 - 15,000
1888
NGO/NPO/NFP/Organization/Association
ROBERT CHARLES GARRETT
$1B - $3B
Hospital
Related Companies
About HMH HOSPITALS CORPORATION
HackensackUMC is a research and teaching hospital that provides inpatient and outpatient services.
