Nurse Care Manager - Somerset, NJ

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.QualificationsRequired:Associates Degree in Nursing requiredExperience in either Utilization Management, Case Management, Disease Management, Care Coordination, or Discharge PlanningPreferred:Bachelors Degree in nursing from an accredited school, preferredTwo years' registered nurse experience in critical care, population health management, or acute care preferredPrior telephonic care experience a plusCertifications and Licenses Required:Current, unrestricted New Jersey nursing license with the ability to obtain licensure in other statesEssential Job FunctionsReviews all patients identified for review to determine the medical necessity and appropriateness of enrollment in the care management programAssesses all assigned patients and integrates family information from social work to collaboratively determine potential, actual and the next level of care neededHolds, interprets, and integrates the patient’s story into the overall multidisciplinary plan of careCoordinates and facilitates access to services and patient care progression using best practice interventions that will produce favorable patient outcomesCollaborates with physicians, nursing, social work, and multiple disciplines, departments, payers, and agencies to eliminate barriers to efficient delivery of care in the appropriate settingWorks with patients to plan and monitor care by assessing patient’s unmet health and social needsDevelops a care plan with the patient, family, caregivers, and providersMonitors adherence to care plans, evaluates effectiveness, and monitors patient progress in a timely mannerActively participates in clinical performance improvement activities as assignedBuilds a network of positive working relationships that advocate for the patientDocuments clinical activities in the medical record and supports and coaches accurate clinical documentation by physicians and othersPursues continuing education in area of expertise and leadershipPerforms other duties as assignedOther 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.

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