Rutgers, The State University of New Jersey is seeking a Senior Care Coordinator Specialist for the Environmental and Occupational Health Sciences Institute. In accordance with professional case management standards, skillfully assesses, advocates, plans, implements, coordinates, monitors, and evaluates health care options and services to meet needs of the patient in the medical neighborhood. The Senior Care Coordination Specialist performs case management and associated administrative duties in compliance with the contractual requirements of a federal health program.
Addresses the medical, nursing and/or personal care needs of the patient to enable their return to an optimal level of functioning.
Conducts a comprehensive needs and risk assessment of the patient (and family/caregiver with consent) to prioritize needs and resource allocation.
Identifies support systems that indicate actual or potential problems and sets health care goals based on needs and risk assessment findings.
Assesses the member's progress towards identified care goals and collaborates with the multidisciplinary health care team to adjust the patient's care plan, as medically appropriate.
Ensures referrals are coordinated and service summary reports are maintained in the electronic health record (EHR) system.
Reviews programmatic medical claims for clinical appropriateness. Assesses pre-and post-authorization compliance and assists in auditing activities to ensure medical records are complete and in accordance with federal standards.
Participates in quality improvement activities to promote effective and efficient case management for patients.
Minimum Education and Experience:
Bachelor's Degree in Nursing or a health care related field required. Certification in case management and at least two (2) years of case management experience required.
Registered Nurse with a license to practice in the State of New Jersey.
Required Knowledge, Skills, and Abilities:
Must be proficient in MS Office which includes Word, Access, Excel software and Microsoft Outlook.
Knowledge of EMR (Electronic Medical Records) required.
Oncology nurse experience preferred.
Posting Number: 18ST1796
Location: Newark (RBHS)
Internal Number: 67678
About Rutgers University
Rutgers, The State University of New Jersey, is a leading national public research university and the state's preeminent, comprehensive public institution of higher education. Rutgers is dedicated to teaching that meets the highest standards of excellence; to conducting research that breaks new ground; and to turning knowledge into solutions for local, national, and global communities. As it was at our founding in 1766, the heart of our mission is preparing students to become productive members of society and good citizens of the world. Rutgers teaches across the full educational spectrum: preschool to precollege; undergraduate to graduate and postdoctoral; and continuing education for professional and personal advancement. Rutgers is New Jersey's land-grant institution and one of the nation's foremost research universities, and as such, we educate, make discoveries, serve as an engine of economic growth, and generate ideas for improving people's lives.