RN II – Oncology Case Manager

Vaga não está no LinkedIn

🕒 5 dias atrás

🦌 Connecticut, New Jersey, +2 estados a mais – Remoto

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $79.100 - $105.945 / ano

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

👔 Gerente

🚫👨‍🎓 Sem graduação necessária

👻 Score fantasma 15%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

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Horizon Connect @ Wall BCBSNJ

SiteLinkedInTodas as Vagas

2 - 10 funcionários

⚕️ Seguro de Saúde

🏥 Saúde

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ é uma presença no LinkedIn ou programa/escritório local associado ao Horizon Blue Cross Blue Shield de New Jersey (BCBSNJ). Com base no nome e no contexto, parece estar conectado às operações de seguro de saúde do Horizon BCBSNJ e ao alcance local ou envolvimento de membros/provedores na área de Wall, NJ. As informações disponíveis publicamente são limitadas e consistem principalmente na interface do site do LinkedIn em vez de um perfil da empresa, então essa descrição é conservadora e baseada na afiliação indicada pelo nome.

Descrição

• Perform RN duties using established guidelines to ensure appropriate level of care and plan transitions to the continuum of care • Assess patients’ clinical needs against guidelines and standards for medically appropriate inpatient care and length of stay • Evaluate the necessity, appropriateness and efficiency of medical services and procedures • Coordinate and assist with implementation of member care plans • Monitor and coordinate out-of-network and out-of-area services and negotiate fees when appropriate • Coordinate with patients, families, physicians, hospitals and external customers from diagnosis to outcome • Coordinate high-quality, cost-effective care across the continuum • Monitor medical care activities and outcomes for appropriateness and effectiveness • Advocate for members and families across care sites and coordinate resource utilization • Encourage member participation and compliance in case/disease management programs • Document accurately and comprehensively according to practice standards and organizational policies • Communicate with multidisciplinary teams telephonically and/or in person • Evaluate care, analyze variances and participate in quality improvement programs • Mentor and train new RNs and staff • Act as a subject matter expert for projects, committees and user acceptance testing for the medical management system • Assume leadership activities in the team lead’s absence • Represent clinical teams and present reports at committee meetings • Outreach to members needing Clinical Advocate services • Apply critical thinking and clinical expertise to maximize outcomes • Build trusting relationships using Motivational Interviewing techniques • Explain employer-sponsored benefits, claims, care coordination and complex needs in plain language • Advocate throughout members’ healthcare journeys and focus on whole-person support • Work an 8- or 10-hour workday Monday through Friday, varying between 8am and 11pm

🎯 Requisitos

• High School Diploma/GED required • Bachelor degree preferred or relevant experience in lieu of degree • Minimum of two (2) years clinical experience • Minimum of two (2) years’ experience with health care payer experience • Active Unrestricted NJ RN License or active Compact License Required • CCM certification preferred • Proficiency in personal computers and Windows-based software, including MS Office (Word, Excel, PowerPoint and Outlook) • Knowledge of intranet and internet applications • Knowledge of hospital structures and payment systems • Working knowledge of case/care/disease management principles • Working knowledge of utilization, case and/or disease management processes • Knowledge of health care contracts and benefit eligibility requirements • Knowledge of mentoring operations for utilization/case/disease management • Ability to work specified weekends and holidays for Utilization Management roles, as required by department needs • Employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

🏖️ Benefícios

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement