Nursing - RN Level 2

1 day ago

Newark, United States Integrated Resources Full time

Job Description: Job Summary:
This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized.

Responsibilities:

1. Assesses patient's clinical need aProductst established guidelines and/or standards to ensure that the services provided are medically appropriate to members needs and aligned with benefit structure.
2. Evaluates the necessity, appropriateness and efficiency of service provided.
3. Develops, coordinates and assists in implementation of services to meet the needs of the members.
4. Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
5. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care.
6. Monitors patient's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness.
7. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
8. Refers members to MLTSS when appropriate.
9. Educates members on the availability of SNP if appropriate.
10. Documents accurately and comprehensively based on the standards of practice and current organization policies.
11. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care.
12. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.
13. Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
14. Completes other assigned functions as requested by management.
15. Performs duties as assigned by management.

Role Notes from Pontoon/Manager Call:
- Temp to Perm potential
- "Remote" role; The role is considered a Field role and does not involve going into the office, rather traveling for assessments in the North NJ area (Union and Hudson Counties)
- A Valid Driver License is needed
- Worker will do first two weeks of training at the Hopewell location
-Reimbursement for mileage is available

-Hours are (8-5/9-5) and the worker will be visiting on average 3/4 members a day for assessments
- This is a very independent role, the worker will need to be a self starter, that is very organized, Tech and Computer fluent, and great at taking detailed notes.
- This role is only available for RNs please do not submit LPNs for this opportunity

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