Case Manager RN - Field, Essex

• Assess, plan, implement, and coordinate case management activities
• Evaluate members' medical needs to facilitate overall wellness
• Develop proactive plans of care addressing identified issues and improving short- and long-term outcomes
• Use clinical tools and data review to evaluate member needs and benefits
• Apply clinical judgment to reduce risk factors and barriers and address complex health and social indicators
• Conduct assessments using information from claims and other sources, including co-morbidities and multiple diagnoses
• Use a holistic approach to determine referrals to clinical resources and interdisciplinary team members
• Collaborate with supervisors and healthcare stakeholders to overcome barriers and meet goals
• Present cases at interdisciplinary case conferences
• Follow regulatory and company case management policies and procedures
• Use motivational interviewing to maximize member engagement and assess health status and needs
• Meet members face to face in the assigned Essex County area

• Minimum 3+ years of clinical practice experience
• Active and unrestricted RN licensure in New Jersey
• Must reside in Essex County, New Jersey
• Willing and able to travel 25–50% of the time using own vehicle
• Reliable transportation required
• Associate's Degree in Nursing
• Certified Case Manager preferred
• Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred
• Confidence working at home and as an independent thinker
• Excellent analytical and problem-solving skills
• Effective communication, organizational, and interpersonal skills
• Ability to work independently
• Effective computer skills, including navigating multiple systems and keyboarding
• Proficiency with MS Word, Excel, Outlook, PowerPoint, and proprietary applications
• Bilingual preferred

Demonstrates expertise in case management activities, including assessment, planning, and implementation of care plans. Proficient in using clinical tools and data to evaluate member needs while adhering to regulatory policies and fostering collaboration with interdisciplinary teams.

• RN Licensure in New Jersey
• Case Management Experience
• Motivational Interviewing
• Analytical and Problem-Solving Skills
• Effective Communication Skills

• Clinical Assessment
• Care Planning
• Data Evaluation
• Risk Factor Reduction
• Holistic Approach
• Discharge Planning
• Home Health Care Coordination
• Bilingual Communication

• Interpersonal Skills
• Organizational Skills
• Independent Thinking

• Certified Case Manager

• Healthcare Stakeholders
• Regulatory Compliance
• Member Engagement
• Co-Morbidities
• Interdisciplinary Team Collaboration

• MS Word
• MS Excel
• MS Outlook
• MS Power Point
• Proprietary Applications