Nurse Case Manager

We are currently seeking a Nurse Case Manager to join our Wall, NJ office! This position will handle telephonic utilization review and medically manage the treatment of our customers injured in an automobile accident. This will be in accordance with Plymouth Rock's Decision Point Review Plan, Department of Insurance and Banking requirements and Care Path Guidelines. Additional responsibilities include but are not limited to the following: Essential Duties and Responsibilities
Medically manage individual injuries by obtaining and assessing medical information related to the injury.
Document case activities and action plans.
Respond to incoming phone calls and faxes on a timely basis to ensure required time frames are met and to provide excellent customer service.
Work closely with our Medical Directors and the treating providers to assess, implement, and evaluate medical treatment provided to the injured person.
Schedule independent medical examinations.
Address all aspects of pre-certification from conservative treatment through invasive treatment.
Follow a strict adherence to Care Path guidelines.
Essential Education and Experience
Current New Jersey RN or LPN license.
Solid oral and written communication skills.
Organized, motivated, self-starter.
Excellent medical assessment skills.
Minimum of 2 years clinical experience.
Proficient computer keyboard skills.
Prior utilization review experience from a NJ Automobile, Workers Comp, or Managed Care company is a plus.



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