Case Manager (RN) Case Management per Diem Day

Job Overview

Since 1882, Jersey City Medical Center has provided Hudson County with advanced, state-of-the-art medical treatment across various disciplines. Jersey City Medical Center, among many accolades, has earned 14 "A" national safety ratings from the Leapfrog Group since the program's inception in 2012, was awarded Magnet Recognition for superior nursing, was named Best Regional Hospital by US News and World Report and ranked among the 100 best places to work in healthcare (nationally). Jersey City Medical Center is also ideally located— in the vibrant Jersey City waterfront community overlooking the harbor, just 10 minutes from New York City, with a grand view of the Statue of Liberty.

Qualifications

• BSN
• Current RN License in NJ
• Minimum of 3 - 5 years’ experience in a hospital setting, Case Management, Utilization Management or Home Care
• 1 or more years utilization review / discharge planning experience
• Preferred: Successful completion of all Orientation Programs, Strong communication and organizational skills, Proficient computer Skills, Strong critical thinking and assessment skills, Knowledge of system applications and EMR

Certifications and Licenses Required

• Active NJ RN license or compact RN license with NJ endorsement
• BLS from the American Heart Association
• ACM or CCM certification
• ERAC certification is required within 6 months of hire and will be arranged by RWJBH
• Certification as required by law, stature, and or regulation of area or specialization

Scheduling Requirements

• Day Shift
• Per Diem
• Scheduled as needed with a minimum requirement of 3 shifts a month, 1 day being a weekend
• Will need to work 1 winter and 1 summer holiday

Essential Functions

• Provides direct case management services to patients and their families utilizing an interdisciplinary team approach
• Conduct comprehensive assessments in the electronic health record
• Develop and implement individualized clinical interventions to support safe discharge, reduce readmissions, and coordinate care
• Participate in interdisciplinary rounds (IDR), presenting cases and communicating discharge planning updates
• Utilize health risk assessments and Social Determinants of Health (SDOH) screenings to identify at-risk patients and coordinate appropriate referrals
• Complete timely referrals for post-acute care services (e.g., DME, home care, facility placement) using electronic referral systems
• Ensure compliance with CMS Conditions of Participation, HIPAA, and organizational policies
• Collaborate with the Utilization Review team to support insurance authorization and clinical documentation needs
• Demonstrate working knowledge of utilization management, level of care criteria, and payment models (e.g., Medicare FFS, bundled payments, managed care)
• Proactively manage patient flow by identifying discharge barriers and escalating complex issues to appropriate leaders
• Address healthcare-related social needs by assessing and coordinating appropriate SDOH services to support safe discharges
• Participate in ongoing professional development, quality improvement, and department-wide initiatives focused on LOS reduction, performance, and engagement
• Serve as clinical nursing resource to the interdisciplinary team by synthesizing patient assessment data, monitoring progression of care, and advocating for timely interventions that align with best practices
• Demonstrate subject matter expertise in nursing assessment, application of utilization review criteria, and the interpretation of patient status in order to ensure clinical appropriateness and regulatory compliance

Benefits and Perks

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retail Plans
• Short- & Long-Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Equal Opportunity Employer

RWJBarnabas Health is an Equal Opportunity Employer