Description
As an RN Case Manager, you will ensure injured workers receive high quality, evidence-based, and cost-effective medical treatment focusing on restoration of function, return to work and/or maximum medical improvement. The official NJM job title is Medical Management Coordinator.
Job Responsibilities:
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and overall evaluation of individual claimant needs.
Facilitate the Injured Worker's rehabilitation by coordinating medical treatment, advocate for the Injured Worker with all medical providers and stakeholders and educate the Injured Worker on their recovery process.
Understand, apply, and comply with all statutory, regulatory, licensing requirements, and NJM policies/guidelines that affect utilization review, case management, and medical management.
Attend on-site visits with Injured Worker, physicians and other treatment providers, when necessary.
Evaluate the appropriateness, medical need and efficiency of health care procedures and facilities according to established criteria or guidelines.
Effectively communicate and collaborate with management, peers, and colleagues to ensure alignment, compliance and effective management of assigned claims.
Participate and/or support identified project initiatives
Proactively seek development opportunities and identify business process improvements to maximize effectiveness of operations and minimize cost.
Required Skills & Qualifications:
Active, unrestricted RN license in NJ, PA, or a COMPACT license.
Minimum of 3 years acute care nursing experience (Med-Surg or Critical Care preferred), Utilization Management Review/Hospital concurrent reviews, and/or Workers' Comp Case Management
Ability to travel within State of NJ/assigned territory dependent on business needs.
Bachelor of Science in Nursing (BSN) is preferred.
Certified Case Manager (CCM) beneficial.
Strong internal and external relationship management skills
Detail oriented with exceptional time management and organizational skills.
Intermediate Microsoft Office Suite skills (Outlook, Word, Excel, PowerPoint) with ability to navigate technology and multiple systems effortlessly.
Compensation: Salary is commensurate with experience and credentials.
Pay Range: $82,534-$95,854Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses.
Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
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