New Jersey Licensed RN Reviewer

Job Summary

Responsible for assessing and coordinating care, the full-time New Jersey Licensed RN Reviewer will evaluate patient needs, implement care plans, and ensure appropriate levels of care while working remotely.

Key responsibilities:

• Assess patients' clinical needs against established guidelines to ensure appropriate inpatient care
• Coordinate and implement care plans, advocating for members and monitoring service delivery
• Document care activities accurately and participate in quality improvement initiatives to enhance member outcomes

Required qualifications:

• Active Unrestricted NJ RN License or active Compact License required
• High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree
• Minimum of two (2) years of clinical experience required
• Knowledge of case/care management principles and utilization management preferred
• Proficiency in personal computers and supporting software in a Windows-based environment preferred