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Case Manager RN
Career Insights for Nurse Case Manager
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Based on New Jersey data
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What they do
A Nurse Case Manager applies nursing expertise to coordinate a patient's medical care and provides advocacy to help them get the best and most affordable care. Develop care plans including discharge planning, coordinate delivery among providers, and teach patients and families how to follow the plan. They may also help patients navigate insurance and other healthcare bureaucracies and access related social services. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment.
$84,150 / year median in New Jersey
+1% projected growth
Job Description
Location:
Hybrid-working remotely and traveling locally 25-50% of the time in Essex, Passaic, Hudson, Sussex, Morris, Bergen New Jersey (will be reimbursed for mileage).Schedule:
Monday-Friday, 8:00 AM-5:00PM EST Contract Length:
6-month contract with potential for long term based on performance and business needs. Position SummaryThe RN Case Manager utilizes a collaborative process of assessment, planning, facilitation, care coordination, and advocacy to help members access appropriate healthcare services and resources. Through comprehensive telephonic assessments and clinical review, the Case Manager develops individualized care plans, coordinates services, and promotes optimal, cost-effective health outcomes. This position requires strong clinical judgment, critical thinking, and the ability to work independently in a fully remote environment. Key Responsibilities Conduct comprehensive telephonic assessments using standardized clinical assessment tools for members enrolled in Managed Long-Term Services and Supports (MLTSS).Assess members' medical needs, eligibility, and benefit plans to determine appropriate services and referrals, including: Adult Medical Day CarePediatric Medical Day CarePersonal Care Assistant (PCA) ServicesNursing Facility Custodial CarePersonal P reference Program (PPP)MLTSS EnrollmentUtilize clinical tools, member information, and data review to evaluate healthcare needs and identify appropriate internal and external resources.Develop individualized, cost-effective care plans that support members' health goals.
Coordinate care with members, authorized representatives, primary care providers, specialists, and interdisciplinary care teams.
Schedule and participate in interdisciplinary care meetings to support safe transitions and continuity of care.
Apply established clinical criteria, case management guidelines, regulatory requirements, and company policies when making care management decisions.
Advocate for members to ensure timely access to medically appropriate services.
Work with diverse populations, including pediatric and medically complex members.
Maintain accurate, timely documentation within the electronic health record.
Utilize critical thinking and problem-solving skills to support effective case resolution.
Follow case management and quality management processes in compliance with regulatory and accreditation standards.
Mentor new team members after achieving proficiency in the role. Required Qualifications Active, unrestricted Registered Nurse (RN) license in the State of NJ.Associate degree in Nursing or higher.
Minimum of 3 years of clinical experience in a hospital, home health, ambulatory care, or similar clinical setting.
Strong assessment, documentation, and care coordination skills.
Ability to work independently in a remote environment. Preferred Qualifications Case management and/or discharge planning experience.
Managed care experience.
Crisis intervention experience.
Case Management Certification (CCM).
Equal Opportunity Employer:
Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility). This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.