New highly competitive pay rates for Case Manager RNs!
This position is for a Case Manager and includes Utilization Review and Discharge Planning. The case manager will be working closely with the Attending MD, and Physician Advisor while utilizing MCG guidelines to determine the appropriate level of care for admission and continued stay. Initial and continued stay reviews will be communicated with the appropriate payor to ensure timely and proper reimbursement. In addition, the case manager will be working closely with the social worker to ensure and facilitate a safe and timely discharge to the home or a lower level of care.
The Case Manager ensures that the attending MD and the CM on the medical floor are aware of pt status and the need for immediate follow up. In addition, this case manager will work with the team and Social Worker to assist patients who do not require admission but do require services/assistance. The Case Manager will also perform initial and continued insurance clinical reviews for determination of approval by payors. The Case Manager will also be responsible for completing assessments and discharge planning as determined by the patient needs.
New Jersey RN license required.
National Case Management Certification or pertinent clinical specialty certification preferred.
Minimum of 3 years medical-surgical or other clinical experience.