RN Case Manager

7 days ago


Cliffside Park, New Jersey, United States VNS Health Full time
Job Title: RN Case Manager, Acute Care Case Management

VNS Health is seeking a dedicated Registered Nurse (RN) Case Manager to assess member needs, identify solutions for high-quality health care services, and manage requests for medical services.

Key Responsibilities:
  • Conduct comprehensive reviews related to requests for services and clinical records
  • Ensure compliance with state and federal regulatory standards
  • Participate in case conferences and identify opportunities for alternative care options
  • Review covered services in accordance with plan benefits and regulatory requirements
  • Maintain accurate records of all care management
  • Participate in special projects and perform other duties as assigned
Requirements:
  • Current license as a Registered Professional Nurse or Occupational Therapist in New York State required
  • Certified Case Manager preferred
  • For SelectHealth ETE Only: Nurse Practitioner certification with background or degree in Public Health preferred
  • Associate's Degree in Nursing or a Master's degree in Occupational Therapy required
  • Minimum two years of experience in cost containment /case management background or acute inpatient hospital experience in chronic or complex care required
  • Excellent organizational and time management skills
  • Knowledge of Medicaid and/or Medicare regulations required

VNS Health offers a range of benefits to support your career and well-being, including referral bonus opportunities, generous paid time off, health insurance, and more.


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