In conjunction with the PCP member member’s family and other pertinent members of the Interdisciplinary Care Team (IDT) CM completes a comprehensive assessment and develops a Person Centered Service Care Plan utilizing clinical expertise to evaluate the member’s need for alternative services.
Assesses short-term and long-term needs and establishes case management objectives.
Manages 75 to 100 active cases based on case intensity and acuity.
Responsible for Utilization Management and uses prescribed criteria to provide timely appropriate and medically necessary service authorizations.
Interacts continuously with member family physician(s) IDT members and other providers utilizing clinical knowledge and expertise to determine medical history and current status.
Must have clear and active RN license in the state of NJ- BSN
At least 1 year of care/case management experience
Ability to work in a fast paced environment with changing priorities and prioritize workload
Ability to create review and interpret treatment plans Ability to create review and interpret treatment plans
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