RN II, Primary Nurse Care

About the position This position is responsible for performing RN duties for the Primary Nurse population, ensuring appropriate levels of care and planning for transitions in care. The role involves outreach to high-risk members, engaging them in preventative care opportunities, and developing member-centric care plans. The Primary Nurse will also serve as a mentor and trainer to new RNs and other staff as needed. Responsibilities • Assess member's clinical needs against established guidelines to ensure medically appropriate services. , • Facilitate responses to gaps in care for high-risk members, including collaboration with treating providers. , • Evaluate the necessity and efficiency of medical services for acute and chronic health care needs. , • Develop and implement individualized plans of care for members, identifying barriers to self-management. , • Coordinate care with members, families, physicians, and other external customers throughout the continuum of care. , • Monitor medical care activities and outcomes for appropriateness and effectiveness. , • Advocate for members among various sites to coordinate resource utilization and service evaluation. , • Encourage member participation in case/disease management programs. , • Document care accurately based on standards of practice and organizational policies. , • Communicate with multidisciplinary teams to ensure continuity and efficiency in member management. , • Evaluate care through problem-solving and participation in quality improvement programs. , • Serve as a mentor/trainer to new RNs and other staff as needed. , • Present clinical cases during audits by external review organizations. , • Perform other duties as assigned by management. Requirements • High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree. , • Minimum of two (2) years clinical experience required. , • Minimum of three (3) years' experience in the health care delivery system/industry required. , • Experience with health care payer strongly preferred. , • Active Unrestricted RN License required; NJ License and/or Compact License required. , • Valid Driver's License and Insurance required. Nice-to-haves • Bi-lingual proficiency preferred. , • Knowledge of case/care/disease management principles. , • Understanding of fiscal accountability and its impact on resource utilization. Benefits • Comprehensive health benefits (Medical/Dental/Vision) , • Retirement Plans , • Generous PTO , • Incentive Plans , • Wellness Programs , • Paid Volunteer Time Off , • Tuition Reimbursement Apply Job!