New Jersey Licensed RN

To support the delivery of high-quality care, a full-time New Jersey Licensed RN will perform assessments for PCA and MDC services remotely, ensuring appropriate levels of care and services are authorized based on established guidelines. Key responsibilities Assesses patients' clinical needs against established guidelines to ensure medically appropriate services Coordinates with multidisciplinary teams and external customers to manage the continuum of care effectively Documents patient care activities accurately while advocating for members and facilitating resource utilization Required qualifications Active Unrestricted NJ RN License required High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree A minimum of two (2) years clinical experience is preferred Proficiency in MS Office products and knowledge of case/care management principles Working knowledge of utilization management and healthcare contracts preferred