Telephonic Case Manager, RN II
NJM Insurance Group
full-time
Posted on:
Location Type: Remote
Location: New Jersey • United States
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Salary
💰 $79,100 - $105,945 per year
About the role
- Assesses patient's clinical need against established guidelines and/or standards
- Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided
- Coordinates and assists in implementation of plan for members
- Monitors and coordinates services rendered outside of the network
- Acts as subject matter expert for respective area for projects
- Advocates for the member/family among various sites to coordinate resource utilization
Requirements
- High School Diploma/GED required
- Bachelor degree preferred or relevant experience in lieu of degree
- Requires a minimum of two (2) years clinical experience
- Requires minimum of two (2) years’ experience with health care payer experience
- Active Unrestricted NJ RN License or active Compact License Required
- CCM certification preferred
Benefits
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical assessmentmedical services evaluationresource utilization coordination
Soft Skills
advocacycoordinationsubject matter expertise
Certifications
Active Unrestricted NJ RN LicenseCompact LicenseCCM certification