JOB SUMMARY: Provides utilization management and systems review activities for “For My Baby & Me”. Work collaboratively with agency partners and community stakeholders and makes recommendations on protocols and systems to support optimum program/grant outcomes.
ESSENTIAL FUNCTIONS:
- Oversee evaluation activities including the development of effective data collection, monitoring and reporting in compliance with applicable grants (For My Baby and Me).
- Utilizes best practice standards to render medical necessity determinations.
- Analyze, evaluate and measure project outcomes and incorporate results into sustainability and strategic evaluation planning.
- Write process and outcomes reports including quarterly performance assessments including protocol recommendations
- Provides case consultations for complex cases and situations.
- Collaborates with interdisciplinary teams to assess physical, behavioral, social and transitional care needs and assists as needed to develop person centered, integrated, recovery-oriented service plans to meet the needs of the consumer.
- Monitors staff for appropriateness and congruence of application of medical necessity criteria during utilization review process. Provides training to staff as needed.
- Assists in the recommendation of client/consumers care to designated collaborating agencies and monitors care and length of stay.
- Recognizes quality of care issues and reports them appropriately through internal/external processes under the direction of the Nurse Executive/Director of Nursing.
- Implements valid and reliable monitoring tools to conduct both quantitative and qualitative analysis of consumer care/quality measures in accordance with acceptable statistical and quality improvement processes/systems.
- Manages, monitors, and reports on both concurrent and retrospective review of consumer records to ensure consumers received/are receiving the right care, in a timely and cost-effective manner and recommends solutions to improving the efficiency and effectiveness of service delivery via program administration and/or the quality improvement process.
- Provide linkages, referrals, and coordination of care
- Other duties as assigned by nurse executive/director of nursing
Position Requirements
MINIMUM QUALIFICATIONS:
- Master’s Degree in Nursing from accredited university.
- Current, unrestricted license to practice independently as a registered nurse in the state of NJ.
- CPR
- Bilingual preferred
KNOWLEDGE/SKILLS/ABILITIES:
- Experience and knowledge of: Substance abuse treatment, mental health, vocational rehabilitation, community integration programs, peer services, mobile crisis, PACT team, and other community services.
- Experience in QI and program evaluation methodology including planning and execution and reporting.
- Extensive clinical knowledge base.
- Some travel may be involved.
- Strong knowledge about the impact of mental health, substance use disorders and psychosocial stressors on the physical health conditions.
- Excellent verbal and written communication skills and interpersonal skills are essential.
- Strong computer skills, including Excel and database management, including the ability to document while simultaneously taking information over the phone or in person.
ABOUT THE ORGANIZATION: Catholic Charities, Diocese of Trenton is a faith inspired non-profit organization, mission-driven, family-friendly, and passionate about services to our communities. We offer a wide variety of exciting career opportunities in the areas of Direct Care, Clinical, Finance, Human Resources, IT, Marketing, Facilities, Transportation, and Nursing. We offer competitive salaries and comprehensive benefit programs. Catholic Charities is an Affirmative Action / Equal Opportunity Employer, fostering a diverse and inclusive environment for staff as well as for people seeking assistance. To learn more about the agency, please visit our website at: www.catholiccharitiestrenton.org.
https://www.catholiccharitiestrenton.org/careers/
https://www.facebook.com/cctrenton
Job Type: Full-time
Pay: $80,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid sick time
- Paid time off
- Referral program
- Vision insurance
Work Location: In person
