RN Case Manager - Child Services

Healthcare Support Staffing; Woodbridge Township (NJ); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Benefits for full-time employees

Flex schedules

On-going training and development

Job summary

A leading healthcare staffing firm is seeking an experienced RN Case Manager in Woodbridge Township, NJ. The role involves care management for complex cases, requiring a clear RN license in NJ and a minimum of 3 years' pediatric experience. Strong communication skills and knowledge of health insurance are essential. The position offers growth opportunities and flexibility in schedules for full-time employees. Interested candidates should contact Christina Turley for more information.

Qualifications

• Must have clear and active RN license in the state of NJ.
• Must have minimum 3 years of pediatric experience in a hospital or home care setting.
• Requires knowledge of health insurance and benefits.
• Requires knowledge of care management and assessment techniques.
• Strong oral, written, and interpersonal communication skills are required.
• Proficient with computers.

Responsibilities

• Conduct assessments to identify individual needs and develop care plans.
• Implement care plans by facilitating authorizations and referrals.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care plan effectiveness.
• Interface with Medical Directors on treatment plans.
• Negotiate rates of reimbursement.
• Assist in problem-solving with providers and service issues.
• Assist with development of utilization/care management policies.

Skills

Pediatric care experience

Health insurance knowledge

Care management techniques

Strong communication

Computer proficiency

Education

Active RN license in NJ

Job description

HealthCare Support Staffing, Inc. (HSS). HealthCare Support Staffing is a proven industry-leading national healthcare recruiting and staffing firm with relationships across Fortune 100 Health Plans, medical facilities, and healthcare organizations throughout the United States. Connect with one of our Professional Recruiting Consultants today to explore opportunities.

Job Description

The RN Case Manager here will be performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs.

Major Job Duties:

• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Qualifications

What We Look For:

• Must have clear and active RN license in the state of NJ
• Must have minimum 3 years of pediatric experience in hospital or home care setting
• Requires knowledge of health insurance/benefits
• Requires knowledge of care management/case management assessment techniques (case management)
• Strong oral, written, and interpersonal communication
• Proficiency with computers

Additional Information

Are you a Registered Nurse in Naples area looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a Fortune 500 company that provides on-going training and development? Are you interested in working for a company that offers benefits for full-time permanent employees, flex schedules and the opportunity to grow with the company? If you answered “yes” to any of these questions – this is the position for you!

Interested in learning more, contact Christina Turley at 407-478-0332 ext 138 and send your resume to

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