Thursday, December 27, 2012

[WNO] Digest Number 1424

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Digest #1424

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Wed Dec 26, 2012 8:10 am (PST) . Posted by:

"Keith Bogen SPHR" hrslugger2002

Telephonic Case Manager RN - Utilization Review Registered Nurse
CarePoint Health Plans
Jersey City, New Jersey
 
Job Description:
We are seeking two bilingual Telephonic Utilization Review/ Case Manager RNs to assess and interpret patient needs through telephone screenings for CarePoint Health Plans.
 
In these full time, salaried positions, Telephonic Case Manager RNs have the option to work from their own homes, but will need to travel to the CarePoint Health Plans main office in Jersey City, New Jersey on an as needed basis.
 
As a Telephonic Case Manager with CarePoint Health Plans, you will report to the Director of Case Management and collaborate with our interdisciplinary team to enhance the delivery of patient care services focusing on preventive care and health maintenance activities.
 
Tasks include, but are not limited to:
 
*   Efficiently meeting patient needs to assure high quality care and reduce length of stay
*   Reducing resource utilization
*   Ensuring insurance reimbursement
*   Responding to patient and family needs promptly and with compassion and understanding
*   Coordinating plan of care with interdisciplinary team to ensure all critical elements have been communicated to the patient and family
 
Job Responsibilities
As a Case Manager with CarePoint Health Plans, you will draw upon your broad clinical and systems management knowledge base to facilitate patient movement through the acute phase of an illness episode and ensure linkage with post-discharge care providers.
Additional responsibilities include:
 
*   Maintaining communication and working relationships with physicians, hospital administrative and ancillary departments, patient families, after-care agencies and durable medical equipment companies
*   Initiating a discharge plan within 16-24 hours of the patient's arrival into hospital, changing as needed depending upon patient's progress
*   Participating in performance and quality improvement activities
 
Job Requirements
 
As a Telephonic  Case Manager with CarePoint Health Plans, you must maintain a customer-oriented focus, demonstrate a spirit of cooperation and possess a high degree of oral, written and interpersonal skills in all levels of communication.
 
Qualifications include:
 
*   Current New Jersey RN
*   Certified Case Manager (CCM) certification
*   Bilingual Spanish/English preferred
*    3+ years acute hospital Utilization and Case Management experience preferred
*   Current experience (within the past 3 years) with  Medicare and InterQual preferred
 
To apply, please send resume and cover letter to:
 
CarePoint Health Plans
Attention: Dawn O'Neill,  do'neill@carepoint.org
Harborside Financial Center, Plaza Five – Suite 1510, Jersey City, NJ 07311
Office: 201.432.2133    Fax:  908.378.7880
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