RN Case Manager - Utilization Review: On-Site Impact

null; Pemberton Township (NJ); On-site; USD 46,222 - 65,831; Full time

Benefits offered by this job

Healthcare coverage

Generous paid time-off

401K matching contribution

Tuition assistance

Short and long term disability

Life insurance

Meal discount

Dependent care subsidy

Adoption assistance

Free parking

Job summary

Deborah Heart and Lung Center in Browns Mills, NJ is seeking an RN Case Manager for Utilization Review on-site. This role focuses on validating patient placement to the most appropriate level of care using criteria such as InterQual or MCG, securing timely authorizations, and guiding care decisions.

Qualified candidates will have 3–5 years of acute care nursing experience, NJ RN licensure, and preferably case management certification.

Qualifications

• RN licensure in NJ required
• BSN preferred
• 3–5 years acute care nursing experience
• Certification in case management preferred
• Graduate of accredited nursing program or diploma/associate/baccalaureate degree

Responsibilities

• Validate patient placement to the most appropriate level of care using admission criteria (e.g., InterQual/MCG).
• Perform initial and continued stay reviews.
• Secure timely authorization for clinical services with payers.
• Comply with UR process per CMS Conditions of Participation.

Skills

Clinical knowledge

Collaboration

Organizational skills

EHR knowledge

Discharge planning

CMS knowledge

Communication skills

Problem solving

Self-directed

Education

Nursing diploma/degree

BSN preferred

Tools

EHR systems

Job description

Deborah Heart and Lung Center in Browns Mills, NJ is seeking an RN Case Manager for Utilization Review on-site. This role focuses on validating patient placement to the most appropriate level of care using criteria such as InterQual or MCG, securing timely authorizations, and guiding care decisions.

Qualified candidates will have 3–5 years of acute care nursing experience, NJ RN licensure, and preferably case management certification.