RN Nurse Case Manager I/II for Developmentally Disabled - Iselin, NJ 122792
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Nurse Case Manager I/II for Developmentally Disabled - Iselin, NJ 122792
This is an office-based position located at the NJ Health Plan, in Iselin, NJ.
This is a telephonic case manager position with the primary responsibility of performing initial assessments on members. No field work involved.
This Case Manager will assist families and their members with developmental
disabilities to obtain services and support based upon their medical and psychosocial needs. Responsible for performing care management within the scope of licensure for members with chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically.
Primary duties may include, but are not limited to:
· Ensures member access to services appropriate to their health needs.
· Conducts assessments to identify individual needs and a specific care
management plan to address objectives and goals as identified during
· Implements care plan by facilitating authorizations/referrals as appropriate
within benefits structure or through extra-contractual arrangements.
· Coordinates internal and external resources to meet identified needs.
· Monitors and evaluates effectiveness of the care management plan and
modifies as necessary.
· Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
· Assists in problem solving with providers, claims or service issues.