NJM Insurance Group
More Than 100 Years of Earning Trust
RN II Case Manager – Pediatric Oncology
Location
New Jersey
Posted
32 days ago
Salary
$79.1K - $105.9K / year
High School2 yrs expEnglish
Job Description
• Performs RN duties using established guidelines to ensure appropriate level of care
• Planning for the transition to the continuum of care
• Assesses patient's clinical need against established guidelines and standards
• Evaluates the necessity and efficiency of medical services and procedures provided
• Coordinates plan implementation for members
• Monitors and coordinates services rendered outside of the network
• Advocates for the member/family among various sites for resource utilization
• Documents accurately based on standards of practice and policies
• Interacts with multidisciplinary teams to manage continuity of care
• Evaluates care through problem solving and quality improvement participation
Job Requirements
- High School Diploma/GED required
- Bachelor degree preferred or relevant experience in lieu of degree
- Requires a minimum of two (2) years clinical experience
- Requires minimum of two (2) years’ experience with health care payer experience
- Active Unrestricted NJ RN License or active Compact License Required
- CCM certification preferred
- Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint and Outlook)
- Requires knowledge of hospital structures and payment systems
- Requires working knowledge of case/care/disease management principles
- Requires working knowledge of operations of utilization, case and/or disease management processes
- Requires knowledge of health care contracts and benefit eligibility requirements
Benefits
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement