RN Utilization Case Manager, Care Coordination, Part Time, Day

Company: Valley Health System
Location: Paramus
Posted on: May 23, 2025

Job Description:

Position SummaryPerforms concurrent utilization review activities on all patients within the assigned caseload. Collaborates and educates the medical staff on appropriate utilization review guidelines and documentation in accordance with CMS regulations and Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management/ prevention within the assigned caseload.EducationBachelor's degree (BSN) in nursing required.ExperienceMinimum 5 years' experience in clinical nursing, minimum of 3 years in case management/ utilization.Special SkillsRegistered Nurse, Licensed in State of New Jersey, Current acute care clinical knowledge with broad-base medical / surgical background. Demonstrates effective interaction and communication skills. Strong critical thinking, clinical reasoning skills and effective problem-solving. Ability to perform work accurately and pay attention to details, often changing from one task to another without loss of efficiency or composure. Ability to function competently in stressful situations and changing work environment, Ability to work collaboratively within the health- system with patients and families; and with multidisciplinary team members.Job LocationThe Valley Hospital-ParamusShiftDay (United States of America)EEO StatementValley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran's status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment.

Keywords: Valley Health System, Bayonne , RN Utilization Case Manager, Care Coordination, Part Time, Day, Healthcare , Paramus, New Jersey