Registered Nurse, Clinical Care Coordinator, Case Manager, Care Coordination, Per Diem, Day

Valley Health System (New Jersey); Paramus (NJ); On-site; USD 69,000 - 86,000; Full time

Benefits offered by this job

Medical, Dental & Vision

Retirement Plan

Paid Holidays

Tuition Assistance

Employee Assistance Program (EAP)

Job summary

Valley Health System (New Jersey) seeks a Clinical Care Coordinator, Case Manager to coordinate patient progression and transitions of care across acute and ambulatory settings. The role requires a BSN and RN license in New Jersey, with ANCC Case Management Certification preferred.

They will partner with physicians, families, payers, and HORC to ensure appropriate resource utilization and timely discharge planning, while navigating CMS regulations and healthcare reimbursement.

Qualifications

• Bachelor's degree in nursing (BSN) and RN license in New Jersey.
• ANCC Case Management Certification preferred.
• Minimum five years of clinical nursing experience; case management and/or utilization review preferred.
• Knowledge of CMS regulations, Medicare/Medicaid, managed care, and medical reimbursement.
• Strong communication, collaboration, critical thinking, and organizational skills.

Responsibilities

• Coordinate patient progression, utilization management, discharge planning, and transitions of care across the continuum.
• Review admission status and promote appropriate resource utilization and timeliness of patient placement.
• Collaborate with patients, families, physicians, payers, HORC, and interdisciplinary teams to optimize outcomes.
• Utilize electronic case management systems and EMR to track patients and progress.
• Balance clinical, operational, and regulatory priorities in a fast-paced environment.

Skills

Care coordination

Discharge planning

Utilization management

Clinical reasoning

Communication

Collaboration

Problem solving

Organizational skills

Education

BSN degree

RN license in NJ

ANCC Case Management Certification (preferred)

Tools

Electronic Medical Records

Case management software

Patient tracking systems

Job description

Position SummaryThe Clinical Care Coordinator, Case Manager is responsible for coordinating patient progression, utilization management, discharge planning, admission status review, and transitions of care across the continuum. The role collaborates with patients, families, physicians, payers, Hospital Operations Resource Center (HORC), Physician Advisors, and interdisciplinary team members to promote appropriate resource utilization, timely patient placement, optimal clinical outcomes, regulatory compliance, and efficient patient throughput. Specialty assignments may include inpatient services, surgical services, or emergency department operations.EducationBachelor's degree (BSN) in nursing required. Registered Nurse. Licensed in State of New Jersey.ANCC Case Management Certification preferred.ExperienceMinimum five (5) years of clinical nursing experience required. Experience in medical or surgical, perioperative, procedural, or emergency nursing preferred. Experience in case management and/or utilization review strongly preferred.Knowledge, Skills and AbilitiesDemonstrates knowledge of acute care nursing, care coordination, discharge planning, utilization management, patient progression, medical necessity criteria, admission status determination, CMS regulations, Medicare, Medicaid, managed care requirements, and healthcare reimbursement.Knowledge of MCG guidelines, care transitions, patient throughput processes, and electronic case management systems is required.Demonstrates strong communication, collaboration, critical thinking, clinical reasoning, problem-solving, and organizational skills.Effectively partners with physicians, patients, families, payers, and interdisciplinary healthcare teams while managing multiple priorities and facilitating patient progression.Proficient in electronic medical records, case management software, and patient tracking systems.Able to assess complex clinical situations, coordinate care across multiple disciplines, facilitate timely transitions, and make sound decisions regarding patient progression and resource utilization.Maintains professionalism and effectiveness in a fast-paced environment while balancing clinical, operational, and regulatory priorities.Job LocationThe Valley Hospital-ParamusShiftDay (United States of America)BenefitsMedical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)Group Term Life Insurance and AD&D(Full Time Employees)Flexible Spending Accounts and Commuter Benefit PlansSupplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended IllnessRetirement PlanTuition AssistanceEmployee Assistance Program (EAP)Valley Health LifeStyles Fitness Center Membership DiscountDay Care Discounts for Various Daycare FacilitiesSalaryJoining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits.Pay Range: $50.18 - $62.73 (per hour)EEO StatementValley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran’s status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment.