Top 78 Pediatric case manager Jobs in Pennington, Nj

RN II, -Pediatrics Case Manager-REMOTE
Horizon Blue Cross Blue Shield of New Jersey —Hopewell, NJ
- $79,100 - $105,945 a year
- Full-time
- Remote
- Bilingual
- Nursing
- Microsoft Excel
- Health insurance
- Dental insurance
3d
Resource Specialist Care Manager
Imagine Pediatrics —New Brunswick, NJ
- $70,000 - $77,000 a year
- Monday to Friday
- Remote
- Spanish
- Mid-level
- Master's degree
- Health savings account
- Paid holidays
Quick Apply
Registered Nurse - Intermediate Care - Hopewell - Full-time - NIGHTS - ** $5K Sign On Bonus **
Capital Health —Pennington, NJ
- $43.90 - $59.69 an hour
- 8 hour shift
- Nursing
- Surgery
- RN License
- AD&D insurance
- Disability insurance
Speech Pathologist IP Diem - Speech Inpatient - Varied Shifts - Trenton (RMC)
Capital Health —Trenton, NJ
- $56.65 an hour
- 8 hour shift
- Hospital
- BLS Certification
- Inpatient
- Disability insurance
- Health insurance
Registered Nurse - ICU/CCU - Hopewell - Full-Time - NIGHTS - ** $5K Sign On Bonus **
Capital Health —Pennington, NJ
- $43.90 - $59.69 an hour
- 8 hour shift
- Nursing
- Surgery
- RN License
- AD&D insurance
- Disability insurance
12d
Registered Nurse Flex - Inpatient Hold (RMC) - Full-Time - NIGHTS
Capital Health —Trenton, NJ
- $43.90 - $59.69 an hour
- 8 hour shift
- Nursing
- Surgery
- RN License
- AD&D insurance
- Disability insurance
Physical Therapist - Outpatient Pelvic Floor - FT - Day - HPW $15,000 Sign-on Bonus
Capital Health —Pennington, NJ
- $40.19 - $52.51 an hour
- 8 hour shift
- Hospital
- Computer literacy
- BLS Certification
- AD&D insurance
- Disability insurance
Physical Therapist Outpatient Pelvic Floor PT Hopewell $7,500 sign-on bonus
Capital Health —Pennington, NJ
- $40.19 - $52.51 an hour
- 8 hour shift
- Hospital
- Computer literacy
- BLS Certification
- AD&D insurance
- Disability insurance
Case Manager Registered Nurse- Field in Somerset County New Jersey
CVS Health —Township of Franklin, NJ
- $66,575 - $142,576 a year
- Full-time
- Nursing
- Up to 50% travel
- RN License
- Health insurance
- Dental insurance
3d
Speech Pathologist IP Diem Hopewell
Capital Health —Pennington, NJ
- $56.65 an hour
- 8 hour shift
- Remote
- Acute care
- Hospital
- BLS Certification
- Disability insurance
- Health insurance
Part Time/ Per Diem Pediatric RN/QA Case manager - Office Position (25% travel)
Dynamic Home Health Care —Bensalem, PA
- $45 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Mileage reimbursement
- Flexible schedule
Quick Apply
Physical Therapist -FT- Days -Trenton $15,000 Sign-On Bonus
Capital Health —Trenton, NJ
- $40.19 - $52.51 an hour
- 8 hour shift
- Hospital
- Computer literacy
- BLS Certification
- AD&D insurance
- Disability insurance
Registered Nurse - Pre-Admission Testing - Lawrenceville, NJ - Full-time - Day
Capital Health —Township of Lawrence, NJ
- $38.09 - $50.01 an hour
- 8 hour shift
- Nursing
- Surgery
- RN License
- AD&D insurance
- Disability insurance
3d
Case Manager Registered Nurse - Field in Mercer County NJ
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Case Manager Registered Nurse - Field New Jersey
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Health insurance
- Dental insurance
3d
Case Manager Registered Nurse - Field - New Jersey
CVS Health —Trenton, NJ
- $66,575 - $142,576 a year
- Full-time
- Bilingual
- Nursing
- RN License
- Health insurance
- Dental insurance
3d
Social Worker I, Part Time
Rutgers University —New Brunswick, NJ
- $61,512 a year
- Part-time
- Master of Social Work
- Licensed Clinical Social Worker
- Office
- Paid holidays
- Dental insurance
Registered Nurse - Peds ED - Hopewell - PER DIEM
Capital Health —Pennington, NJ
- $49.41 - $51.47 an hour
- 8 hour shift
- Nursing
- Surgery
- RN License
- Disability insurance
- Health insurance
Registered Nurse - NICU - Hopewell - PER DIEM
Capital Health —Pennington, NJ
- $51.47 an hour
- 8 hour shift
- Nursing
- Surgery
- RN License
- Disability insurance
- Health insurance
Clinical Appeals RN - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ
Capital Health —Princeton, NJ
- $92,289.60 - $120,577.60 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- AD&D insurance
- Disability insurance

I want to receive the latest job alert for pediatric case manager in pennington, nj

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

pediatric case manager jobs near pennington, nj

Speech Pathologist jobs in Trenton, NJ

Registered Nurse jobs in Trenton, NJ

Physical Therapist jobs in Pennington, NJ

Social Worker jobs in New Brunswick, NJ

Physical Therapist jobs in Trenton, NJ

Speech Pathologist jobs in Collegeville, PA

Speech Analytics jobs in Remote

Speech Pathologist jobs in Evansville, IN

Speech Utilization Review jobs in Pennsylvania

Speech Language Pathologist jobs in Maine

Speech Pathologist jobs in Arizona

Speech Pathologist jobs in Michigan

Speech Language Pathologist Clinical Fellowship jobs in Philadelphia, PA

Clinical Nurse Educator jobs in Lehigh Valley, PA

Registered Nurse jobs in Longview, TX

Nursing Assistant Nicu jobs in Phoenix, AZ

Registered Behavior Technician Rbt jobs in New York, NY

Correctional Nurse jobs in Essex County, NJ

Registered Nurse jobs in Little Rock, AR

Case Management jobs in Washington, DC

RN II, -Pediatrics Case Manager-REMOTE

Horizon Blue Cross Blue Shield of New Jersey -
Hopewell, NJ

Apply Now

Job Details

Full-time
$79,100 - $105,945 a year
3 days ago

Benefits

Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance
Volunteer time off
Retirement plan

Qualifications

Microsoft Excel
Microsoft Outlook
Utilization review
RN License
Health insurance policy knowledge
Windows
Managing patients as a nurse case manager
Driver's License
Utilization management
Medical treatment knowledge
Task prioritization
Desktop applications
Resource utilization in healthcare
Disease state management

Full Job Description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

About the Role

This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the transition to the continuum of care and developing a member centric plan of care. Primary Nurses will outreach to high risk members and will work to engage members in preventative care opportunities & screenings when possible. This position will perform duties and types of care management as assigned by management. Serves as a mentor/trainer to new RN's and other staff as needed. Positions involving ASO accounts may require some travel for on-site availability.

What You'll Do

Assesses member's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to member's needs and aligned with the benefit structure.
Facilitates response to gaps in care and identified high risk members to appropriate settings of care for annual wellness visits including collaboration with treating provider.
Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided for both acute and chronic health care needs.
Develops, coordinates and assists in implementation of individualized plan of care for members and identification of barriers towards Self-Management and optimal wellness.
Coordinates with members, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care including transitional care.
Monitors member's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness.
Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
Encourages member participation and compliance in the case/disease management program efforts.
Documents accurately and comprehensively based on the standards of practice and current organization policies.
Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care.
Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
Serves as mentor/trainer to new RN's and other staff as needed
Presents clinical cases during audits conducted by external review organizations.

What You Bring

Education/Experience:

Requires an associate's or bachelor's degree (or higher) in nursing and/or a health related field OR accredited diploma nursing school.
Requires a minimum of two (2) years clinical experience. Experience with both acute and chronic conditions preferred.
Requires a minimum of three (3) years' experience in the health care delivery system/industry.
Experience with health care payer experience strongly preferred.

Additional licensing, certifications, registrations:

Active Unrestricted RN License Required; NJ License Preferred
Requires a valid Driver's License and Insurance.

Knowledge:

Requires proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, and PowerPoint) and Microsoft Outlook. Prefers knowledge in the use of intranet and internet applications.
Requires working knowledge of case/care/disease management principles.
Requires working knowledge of operations of utilization, case and/or disease management processes.
Requires working knowledge of principles of utilization management.
Requires basic knowledge of health care contracts and benefit eligibility requirements.
Requires knowledge of hospital structures and payment systems.
Prefers understanding of fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.

Skills and Abilities:

Bi-lingual proficiency preferred.
Adaptability/Flexibility
Analytical
Compassion
Information/Knowledge Sharing
Interpersonal & Client Relationship
Sound decision making
Active listening
Organization Planning/Priority Setting
Problem Solving/Critical Thinking
Team Player
Time Management
Written/Oral Communications

Travel (If Applicable):

Travel primarily within State of NJ may be required. Occasional travel in the tri-state area may also be required.

Why Horizon?

At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you!

Salary Range:

$79,100 - $105,945

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement

Disclaimer:

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

Apply Now

Refine Your Search

pediatric case manager jobs in pennington, nj

RN II, -Pediatrics Case Manager-REMOTE

Resource Specialist Care Manager

Registered Nurse - Intermediate Care - Hopewell - Full-time - NIGHTS - $5K Sign On Bonus

Speech Pathologist IP Diem - Speech Inpatient - Varied Shifts - Trenton (RMC)

Registered Nurse - ICU/CCU - Hopewell - Full-Time - NIGHTS - $5K Sign On Bonus

Registered Nurse Flex - Inpatient Hold (RMC) - Full-Time - NIGHTS

Physical Therapist - Outpatient Pelvic Floor - FT - Day - HPW $15,000 Sign-on Bonus

Physical Therapist Outpatient Pelvic Floor PT Hopewell $7,500 sign-on bonus

Case Manager Registered Nurse- Field in Somerset County New Jersey

Speech Pathologist IP Diem Hopewell

Part Time/ Per Diem Pediatric RN/QA Case manager - Office Position (25% travel)

Physical Therapist -FT- Days -Trenton $15,000 Sign-On Bonus

Registered Nurse - Pre-Admission Testing - Lawrenceville, NJ - Full-time - Day

Case Manager Registered Nurse - Field in Mercer County NJ

Case Manager Registered Nurse - Field New Jersey

Case Manager Registered Nurse - Field - New Jersey

Social Worker I, Part Time

Registered Nurse - Peds ED - Hopewell - PER DIEM

Registered Nurse - NICU - Hopewell - PER DIEM

Clinical Appeals RN - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ

I want to receive the latest job alert for pediatric case manager in pennington, nj

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected