New Jersey Licensed RN

Job Summary

To support the delivery of high-quality care, a full-time New Jersey Licensed RN will perform assessments for PCA and MDC services remotely, ensuring appropriate levels of care and services are authorized based on established guidelines.

Key responsibilities

• Assesses patients' clinical needs against established guidelines to ensure medically appropriate services
• Coordinates with multidisciplinary teams and external customers to manage the continuum of care effectively
• Documents patient care activities accurately while advocating for members and facilitating resource utilization

Required qualifications

• Active Unrestricted NJ RN License required
• High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree
• A minimum of two (2) years clinical experience is preferred
• Proficiency in MS Office products and knowledge of case/care management principles
• Working knowledge of utilization management and healthcare contracts preferred