RN II, Case Manager – Pediatrics

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🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $79.1k - $105.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

🚫👨‍🎓 No degree required

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NJM Insurance Group

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1913

Insurance

NJM Insurance Group is a well-established insurance provider offering a range of personal and commercial insurance products. Their services include auto, homeowners, renters, condo, commercial auto, and business insurance, with a focus on exceptional customer satisfaction and claims experience. NJM is recognized for its outstanding auto claims experience by J. D. Power and is committed to serving customers in states like Connecticut, Maryland, New Jersey, Ohio, and Pennsylvania. The company prides itself on being straightforward and customer-focused, without jingles or mascots, offering trusted insurance solutions and multiple discount opportunities for various policies.

📋 Description

• Performs RN duties using established guidelines to ensure appropriate level of care • Plans for the transition to the continuum of care • Assesses patient's clinical need against established guidelines • Evaluates the necessity, appropriateness and efficiency of medical services • Coordinates and assists in the implementation of care plans for members • Monitors and coordinates services rendered outside of the network • Advocates for members among various sites to coordinate resource utilization • Documents accurately based on the standards of practice • Acts as a subject matter expert for projects and committees • Serves as mentor/trainer to new RN's and staff as needed

🎯 Requirements

• High School Diploma/GED required • Bachelor degree preferred or relevant experience in lieu of degree • Minimum of two (2) years clinical experience required • Minimum of two (2) years’ experience with health care payer experience required • Active Unrestricted NJ RN License or active Compact License Required • CCM certification preferred for Clinical Advocate roles • Proficient in the use of personal computers and MS Office products • Knowledgeable in hospital structures and payment systems • Working knowledge of case/care/disease management principles and processes • Must be able to work collaboratively in a team environment

🏖️ Benefits

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