Care Navigator: Utilization & Discharge Management

Hackensack Meridian Health; Edison (NJ); On-site; USD 97,000 - 119,000; Full time

Job summary

Hackensack Meridian Health invites a dedicated Care Management, Care Coordinator, Utilization Management professional to join our team in New Jersey. The role focuses on coordinating and facilitating the clinical progression of patient treatment while ensuring regulatory and payer requirements are met.

The position emphasizes utilization review, discharge planning, and collaboration with multidisciplinary teams to promote efficient resource use and optimal patient outcomes.

Qualifications

• BSN required or in progress with plan to obtain within 3 years of hire.
• Strong decision-making and problem-solving abilities with leadership skills.
• Excellent verbal, written and presentation skills; proficient in computer use.

Responsibilities

• Follows utilization review workflows including admission reviews and denials; communicates with insurance.
• Obtains and evaluates medical records for inpatient admissions to determine documentation adequacy.
• Reviews charts for appropriateness of admission and length of stay using clinical criteria.
• Collaborates with multidisciplinary teams to support discharge planning and length of stay goals.
• Provides CMS documents to patients and families per regulatory guidelines; maintains competencies in applicable platforms.

Skills

Decision-making

Problem-solving

Leadership

Verbal and written communication

Computer skills

Education

BSN or BSN in progress

Tools

Epic

Xsolis Cortex

Enterprise Analytics

Google Suites

Job description

Hackensack Meridian Health invites a dedicated Care Management, Care Coordinator, Utilization Management professional to join our team in New Jersey. The role focuses on coordinating and facilitating the clinical progression of patient treatment while ensuring regulatory and payer requirements are met.

The position emphasizes utilization review, discharge planning, and collaboration with multidisciplinary teams to promote efficient resource use and optimal patient outcomes.