the smart solution for Camden jobs

RN Care Management Coordinator

Company: ZolonTech
Location: Camden
Posted on: April 16, 2019

Job Description:

Contract - 3 + months Under the direction of a designated Care Management and Coordination Manager, performs telephonic/electronic reviews from providers and members for inpatient and outpatient services. Evaluates the planned procedure or treatment for medical appropriateness and setting as well as ensure application of benefit exclusion. Duties and responsibilities: Performs Clinical Precert reviews for inpatient admissions and outpatient services as well as coverage for a service or procedure. Utilizes medical policy, Care Management and Coordination policy as well as precert binder as guidelines for approvals, contacts attending physicians regarding treatment plans/plan of care and clarifies medical need for requested setting to obtain service. Refers cases to the medical director that do not meet established criteria or medical policy guidelines Performs early identification of hospitalized members to evaluate discharge planning needs. Maintains the integrity of the system information by timely, accurate data entry. Utilization decisions are in compliance with state, federal and accreditation regulations. Ensures that all key functions are documented via Care Management and Coordination Policy. Works to build relations with all providers and provides exceptional customer service. Reports potential utilization issues or trends to designated manager or senior care coordinator and recommendations for improvement. Participates in the process of educating providers on managed care. Is comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable. Builds team spirit and interdepartmental rapport, using effective problem solving and motivational strategy. Performs additional related duties as assigned Knowledge, skills and abilities required: Registered Nurse with active RN license in State of employment. BS preferred. Minimum of one year of acute care clinical experience in a hospital or other health care setting. Prior UM experience is desirable. Skills: Exceptional communication, problem solving, and interpersonal skills; focused, professionalism, action oriented with strong ability to set priorities and obtain results. Organized, demonstrates excellent team management skills Team Player. Ability to effectively utilize time management.

Keywords: ZolonTech, Camden , RN Care Management Coordinator, Executive , Camden, New Jersey

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Executive Jobs

Nurse - Medical Case Manager - Seasonal
Description: Excellence In Everything We Touch Position Summary This is a work from home position requiring local field case management travel. Our ideal candidate must reside in the Eastern PA / Western NJ region. (more...)
Company: Crawford & Company
Location: Camden
Posted on: 04/19/2019

Outside Sales/Route Sales Manager Full Training
Description: Outside Sales/Route Sales Manager Full Training Feel the freedom independence of managing your own protected route
Company: Mac Tools
Location: Jersey City
Posted on: 04/19/2019

Salon Manager-Springfield Mall - Store 556
Description: Salon Manager-Springfield Mall - Store 556 Responsible for meeting or exceeding salon service and pro-hair sales budget through staff recruiting and productivity development salon service promotions (more...)
Company: Ulta Beauty
Location: Springfield
Posted on: 04/19/2019

Telephonic Case Manager-Work From Home
Description: Study Management Associate III - Work from home Can be home-based anywhere in USA - Multiple openings
Company: The Career Hut
Location: Trenton
Posted on: 04/19/2019

Long- Term Unit Manager/ RN Supervisor
Description: OverviewBalance Life Work with a New Career Opportunity br br Skilled Nursing br br Now Hiring - Unit Manager - East brunswick, NJ br br Care One East Brunswick br br The Center's mission (more...)
Company: CareOne
Location: East Brunswick
Posted on: 04/19/2019

RN Director Intensive Care Unit
Description: An outstanding opportunity for a Critical Care ICU Nurse Director is available at an acute-care hospital in Southern New Jersey. This facility is prepared to enhance the Intensive Care Unit team with (more...)
Company: Clinical Management Consultants
Location: Vineland
Posted on: 04/19/2019

Dining Services Manager
Description: Enlivant is seeking a Dining Services Manager at Maidencreek Place in Reading, PA ABOUT US:At our core, we believe the care and service for America s aging population is not only a moral obligation, but (more...)
Company: BernardHodes
Location: Reading
Posted on: 04/19/2019

Audit Manager " Government Contracting (cpa firm) NYC dm
Description: Audit Manager Government Contracting cpa firm NYC dm Salary: 85k 105k Location: NYC Industry: CPA firm CPA firm is seeking a Transfer Pricing Senior for
Company: esr
Location: Newark
Posted on: 04/19/2019

Registered Nurse (RN) Case Manager - Top Pay
Description: RN Case Manager Job Type: Case Manager Location: Hudson, Essex,
Company: Priority Nursing Services
Location: Newark
Posted on: 04/19/2019

Nurse Manager
Description: Nurse Manager We love our patients. We think you will, too. Excel as the superior nurse, mentor and clinical expert you are-and have a dramatic impact on the lives of our patients and their families. (more...)
Company: DaVita
Location: Camden
Posted on: 04/19/2019

Log In or Create An Account

Get the latest New Jersey jobs by following @recnetNJ on Twitter!

Camden RSS job feeds