• Field Nurse Case Manager

    NJM Insurance (Trenton, NJ)


    As an RN Case Manager, you will ensure injured workers receive high quality, evidence-based, and cost-effective medical treatment focusing on restoration of function, return to work and/or maximum medical improvement. The official NJM job title is Medical Management Coordinator.

    Job Responsibilities:

    + Demonstrate knowledge, skills, and competency in the application of case management standards of practice.

    + Develop and provide ongoing support of the rehabilitation plan through comprehensive assessment, planning, implementation, and overall evaluation of individual claimant needs.

    + Facilitate the Injured Worker’s rehabilitation by coordinating medical treatment, advocate for the Injured Worker with all medical providers and stakeholders and educate the Injured Worker on their recovery process.

    + Understand, apply, and comply with all statutory, regulatory, licensing requirements, and NJM policies/guidelines that affect utilization review, case management, and medical management.

    + Attend on-site visits with Injured Worker, physicians and other treatment providers, when necessary.

    + Evaluate the appropriateness, medical need and efficiency of health care procedures and facilities according to established criteria or guidelines.

    + Effectively communicate and collaborate with management, peers, and colleagues to ensure alignment, compliance and effective management of assigned claims.

    + Participate and/or support identified project initiatives

    + Proactively seek development opportunities and identify business process improvements to maximize effectiveness of operations and minimize cost.

    Required Skills & Qualifications:

    + Active, unrestricted RN license in NJ, PA, or a COMPACT license.

    + Minimum of 3 years acute care nursing experience (Med-Surg or Critical Care preferred), Utilization Management Review/Hospital concurrent reviews, and/or Workers’ Comp Case Management

    + Ability to travel within State of NJ/assigned territory dependent on business needs.

    + Bachelor of Science in Nursing (BSN) is preferred.

    + Certified Case Manager (CCM) beneficial.

    + Strong internal and external relationship management skills

    + Detail oriented with exceptional time management and organizational skills.

    + Intermediate Microsoft Office Suite skills (Outlook, Word, Excel, PowerPoint) with ability to navigate technology and multiple systems effortlessly.

     

    Compensation: Salary is commensurate with experience and credentials.

     

    Pay Range: $82,534-$95,854

     

    Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses.

     

    Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.