Job Description:

• Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
• Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work
• Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care
• Communicates with member/client and other stakeholders as appropriate
• Prepares all required documentation of case work activities as appropriate
• Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes
• Provides educational and prevention information for best medical outcomes
• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes

Requirements:

• Active and unrestricted NJ/Compact License
• Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
• Minimum 2+ years CM, discharge planning and/or home health care coordination experience
• Bilingual preferred - Spanish
• Certified Case Manager is preferred
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required
• Associates Degree or Nursing Diploma Required
• Bachelors Degree Preferred

Benefits:

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs