Centralized RN Care Manager- Somerset, NJReq #:0000159926

Category:Nurse Case Manager

Status:Full-Time

Shift:Day

Facility:RWJBarnabas Health Corporate Services

Department:Accountable Care Organization

Location:

SBC Corporation, Somerset, Somerset, NJ 07052

Job Overview:

As part of RWJBarnabas Health s Transform Together team you will play an instrumental role in a department that is providing fully coordinated patient care from a holistic approach to improve the overall performance of the value-based population across the healthcare continuum by ensuring the population receives the right care, at the right time, by the right people,

The RN Care Manager will utilize skilled intervention, clinical best practice knowledge and collaboration with the patient, physician and multidisciplinary treatment team to pace care, achieve quality outcomes and negotiate appropriate reimbursement,

You will ensure the timely and seamless clinical transition of patients through medically appropriate levels of care,

Qualifications:

Required:

• Bachelor's degree in nursing from an accredited school

Preferred:

• Two years' registered nurse experience in critical care, population health management, or acute care preferred

• Experience in either Utilization Management, Case Management, Disease Management, Care Coordination, or Discharge Planning

• Prior telephonic care experience a plus

Certifications and Licenses Required:

• Current, unrestricted New Jersey nursing license with the ability to obtain licensure in other states

Essential Functions:

• Reviews all patients identified for review to determine the medical necessity and appropriateness of enrollment in the care management program

• Assesses all assigned patients and integrates family information from social work to collaboratively determine potential, actual and the next level of care needed

• Holds, interprets, and integrates the patient s story into the overall multidisciplinary plan of care

• Coordinates and facilitates access to services and patient care progression using best practice interventions that will produce favorable patient outcomes

• Collaborates with physicians, nursing, social work, and multiple disciplines, departments, payers, and agencies to eliminate barriers to efficient delivery of care in the appropriate setting

• Work with patients to plan and monitor care by assessing patient s unmet health and social needs

• Develop a care plan with the patient,family, caregivers and providers

• Monitors adherence to care plans, evaluates effectiveness, monitors patient progress in a timely manner

• Actively participates in clinical performance improvement activities as assigned

• Builds a network of positive working relationships that advocate for the patient

• Documents clinical activities in the medical record and supports and coaches accurate clinical documentation by physicians and others

• Pursues continuing education in area of expertise/leadership

• Performs other duties as assigned

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Additional Information:

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

• Paid Time Off (PTO)

• Medical and Prescription Drug Insurance

• Dental and Vision Insurance

• Retirement Plans

• Short & Long Term Disability

• Life & Accidental Death Insurance

• Tuition Reimbursement

• Health Care/Dependent Care Flexible Spending Accounts

• Wellness Programs

• Voluntary Benefits (e.g., Pet Insurance)

• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered,

high-quality academic medicine in a compassionate and equitable manner, while delivering

a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

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RWJBarnabas Health is an Equal Opportunity Employer