New Jersey Licensed RN - Utilization Management

Job Summary

Responsible for performing RN duties using established guidelines, the full-time New Jersey Licensed RN - Utilization Management will assess clinical needs, coordinate care plans, and monitor service delivery in a remote setting, with mandatory weekend and holiday coverage.

Key responsibilities:

• Assesses patients' clinical needs to ensure appropriate levels of care and length of stay
• Coordinates and implements care plans, advocating for members and their families throughout the continuum of care
• Monitors and evaluates the appropriateness and effectiveness of medical services and procedures provided

Required qualifications:

• Active Unrestricted NJ RN License
• Associate's or bachelor's degree in nursing or a health-related field, or accredited diploma nursing school
• Minimum of two years of clinical experience
• Knowledge of case/care management principles and utilization management
• Proficiency in Microsoft Office and familiarity with healthcare contracts and benefit eligibility requirements