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Nurse Case Manager

2 months ago

Hoboken, New Jersey, United States VNS Health Full time
About the Role

VNS Health is seeking a skilled Nurse Case Manager to join our team. As a key member of our healthcare team, you will be responsible for assessing member needs and identifying solutions that promote high-quality and cost-effective healthcare services.

Key Responsibilities
  • Assess and Coordinate Care: Conduct comprehensive reviews of member requests for services, including clinical record reviews and interviews with members, clinical staff, and medical providers.
  • Ensure Medical Necessity: Examine standards and criteria to ensure medical necessity and appropriateness of admissions, treatment, and lengths of stay.
  • Coordinate Transitions: Identify opportunities for alternative care options and contribute to the development of patient-focused plans of care to facilitate safe discharges and transitions back into the community.
  • Ensure Compliance: Ensure compliance with state and federal regulatory standards and VNS Health policies and procedures.
  • Collaborate with Team Members: Participate in case conferences with management and collaborate with community providers to ensure efficient and effective transitions and delivery of care.
Requirements
  • Education: Associate's Degree in Nursing or a Master's degree in Occupational Therapy required.
  • Experience: Minimum two years of experience with strong cost containment/case management background or two years acute inpatient hospital experience in chronic or complex care required.
  • Licenses and Certifications: Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York State required.
About VNS Health

VNS Health is one of the nation's largest nonprofit home and community-based healthcare organizations. Our commitment to health and well-being drives us to provide compassionate care, unparalleled expertise, and 24/7 solutions and resources to those we serve.

Benefits
  • Guaranteed Hours
  • 401k retirement plan
  • Employee assistance programs
  • Dental benefits
  • Vision benefits
  • License and certification reimbursement
  • Life insurance
  • Discount program
  • Holiday Pay
  • Continuing Education
  • Wellness and fitness programs
  • Mileage reimbursement
  • Medical benefits
  • Benefits start day 1