Job Summary
A company is looking for a Registered Nurse.
Key Responsibilities
- Assess patients' clinical needs against established guidelines to ensure appropriate care levels
- Evaluate the necessity and efficiency of medical services and coordinate care plans for members
- Monitor and advocate for patients' medical care activities and outcomes across various service sites
Required Qualifications
- Active NJ or Compact State Nurse License
- Proficiency in personal computers and software in a Windows environment, including MS Office
- Knowledge of hospital structures, payment systems, and care management principles
- Understanding of health care contracts and benefit eligibility requirements
- Experience in mentoring and operations of utilization/case/disease management
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