RN Case Manager - Acute Care & Care Coordination

Deborah Heart and Lung Center; Pemberton Township (NJ); Presencial; USD 46.000 - 66.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K matching

Tuition assistance

Paid time off

Life insurance

Free parking

Meal discount

Descripción de la vacante

Deborah Heart and Lung Center is seeking a Utilization Management nurse to validate patient placement and ensure appropriate levels of care using InterQual/MCG criteria. The role involves reviews, payer communications, and CMS-aligned UM processes to support efficient care and timely authorizations.

The candidate should have 3–5 years of acute care experience, NJ RN licensure, and strong collaboration skills for interdisciplinary teams.

Formación

• 3 to 5 years acute care nursing experience.
• BSN preferred.
• NJ RN licensure; case management certification preferred.

Responsabilidades

• Validate patient placement and level of care using nationally accepted criteria.
• Perform initial and continued stay reviews for appropriateness of tests/procedures.
• Secure authorizations for clinical services with payers.
• Follow UM process per CMS Conditions of Participation.

Conocimientos

Clinical knowledge

Communication

Interdisciplinary teamwork

Discharge planning

Time management

EHR/IT literacy

Care coordination

Problem solving

Payer communications

Adaptability

Educación

Diploma/Associate/Baccalaureate Nursing

BSN preferred

Herramientas

Electronic Health Records (EHR)

Descripción del empleo

Deborah Heart and Lung Center is seeking a Utilization Management nurse to validate patient placement and ensure appropriate levels of care using InterQual/MCG criteria. The role involves reviews, payer communications, and CMS-aligned UM processes to support efficient care and timely authorizations.

The candidate should have 3–5 years of acute care experience, NJ RN licensure, and strong collaboration skills for interdisciplinary teams.