RN Field Case Manager

One of the fastest growing managed care companies in the U.S. - In conjunction with the PCP member member’s family and other pertinent members of the Interdisciplinary Care Team (IDT) CM completes a comprehensive assessment and develops a Person Centered Service Care Plan utilizing clinical expertise to evaluate the member’s need for alternative services. - Assesses short-term and long-term needs and establishes case management objectives. - Manages 75 to 100 active cases based on case intensity and acuity. - Responsible for Utilization Management and uses prescribed criteria to provide timely appropriate and medically necessary service authorizations. - Interacts continuously with member family physician(s) IDT members and other providers utilizing clinical knowledge and expertise to determine medical history and current status. - Must have clear and active RN license in the state of NJ- BSN  - At least 1 year of care/case management experience - Ability to work in a fast paced environment with changing priorities and prioritize workload - Ability to create review and interpret treatment plans Ability to create review and interpret treatment plans - Ability to implement process improvements - Proficient with computers and MS apps All your information will be kept confidential according to EEO guidelines.