Nursing Jobs in West Orange, NJ
$85,000 - $106,300 / year
Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state and federal regulations. Delivers timely notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost effective. Works under general supervision. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do Conducts comprehensive review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical providers, paraprofessional staff, caregivers and other relevant sources as necessary. Examines standards and criteria to ensure medical necessity and appropriateness of admissions, treatment, level of care and lengths of stay. Performs prior authorization and concurrent reviews to ensure extended treatment is medically necessary and being conducted in the right setting. Reviews requests for outpatient and inpatient admission; approves services or consults with medical directors when case does not meet medical necessity criteria. Ensures compliance with state and federal regulatory standards and VNS Health policies and procedures. Participates in case conferences with management. Identifies opportunities for alternative care options and contributes to the development of patient focused plan of care to facilitate a safe discharge and transition back into the community after hospitalization. Reviews covered and coordinated services in accordance with established plan benefits, application of evidenced based medical criteria, and regulatory requirements to ensure appropriate authorization of services and execution of the plan’s fiduciary responsibilities. Identifies and provides recommendations for improvement regarding department processes and procedures. Maintains current knowledge of organizational or state-wide trends that affect member eligibility and the need for issuance of Determination Notices Improves clinical and cost-effective outcomes such as reduction of hospital admissions and emergency department visits through on-going member education, care management and collaboration with IDT members. Provides input and recommendations for design and development of, processes and procedures for effective member case management, efficient department operations, and excellent customer service. Maintains accurate record of all care management. Maintains written progress notes and verbal communications according to program guidelines. Participates in approval for out-of-network services when member receives services outside of VNS Health network services. Provides case direction and assistance ensuring quality and appropriate service delivery. Keeps current with all health plan changes and updates through on-going training, coaching and educational materials. Assesses, plans, facilitates and advocates for options and services to effectively manage an individual’s health needs. Promotes quality and cost-effective outcomes at all times. Provides telephonic case management to members, balancing clinical, social, and environmental concerns. Provides analysis of initial health evaluation and comprehensive assessment of the member/family psychosocial status and case management needs. Participates in the development, coordination and implementation of the care plan to address specific needs of the member/family including thorough transitions between settings of care. Coordinates with community providers to ensure efficient and effective transitions and delivery of care in the home and community. Consults with the member, family, and members of the inter-disciplinary team to coordinate the treatment plan, education, self-care techniques and prevention strategies. Verifies that all aspects of the clinical record are in agreement with the member’s clinical and functional status. Utilizes VNS Health and state approved assessment and documentation as well as interviews with members, family, and care providers in decision-making. Performs annual clinical co-visits for nurses as well as two initial co-visits during the first six months for new hires as follows: one within first three weeks and a second within the first six months. Provides feedback to therapist and management; assists in development of plans to address improvement needs as appropriate. Participates in special projects and performs other duties as assigned. Qualifications Licenses and Certifications: Current license to practice as a Registered Professional Nurse in New York State required Certified Case Manager preferred Education: Associate's Degree in Nursing required Bachelor's Degree or Master’s degree in nursing preferred Work Experience: Minimum two years of experience with strong cost containment /case management background or two years acute inpatient hospital experience in chronic or complex care required Must have experience and qualifications demonstrating knowledge of working with the LTSS eligible population. preferred Knowledge of Medicare and Medicaid regulations required Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills. Working knowledge of Microsoft Excel, Power-Point, and Word and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred Pay Range USD $85,000.00 - USD $106,300.00 /Yr. About Us VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day. Looking for Certified Home Health Aides - Full time/Part time work available - Weekly pay for Certified Home Health Aides - Supportive environment - Flexible schedules - Sign on bonus Seeking a great company to work for? - Join our growing team of Certified Home Health Aides - Top dollar paid weekly - Supportive office staff - Flexible schedules - Sign on bonus for Certified Home Health Aides Looking to get paid to do what you love? - Sign on bonus - Best pay in the market - Evening hours available - Immediate openings for Certified Home Health Aides Pay range: $14-$17/hour Sign on bonus of $100 - $150 
$130,000 - $135,000 / year
Caring Angels Home Care is looking for a full-time Float Nurse with Oasis experience for our Home Care geriatric patients in Queens. As a Geriatric CHHA Nurse, you will play an integral role in the agency's nursing care division. This position offers a $130,000.00-$135,000.00 salary plus an excellent benefits package which includes: Medical and Dental insurance, 401k Plan after only 3 Months of Employment, 27 Paid Time Off Days, 10 Paid Holidays, Car Service or Mileage Reimbursement, Only 35 points weekly! Our agency has won numerous awards for employee satisfaction and patient care. Job Requirements Must have accredited NY Registered Nurse License. Must have experience documenting with Oasis. This position offers a competitive salary and benefits package. Interested applicants please apply. Job Type: Full-time Benefits: Flexible schedule Health insurance Paid time off License/Certification: New York State RN License (Required) Work Location: In person Job Type: Full-time Benefits: Flexible schedule Health insurance Paid time off License/Certification: New York State RN License (Required) Work Location: In person 
$98,200 - $130,800 / year
Overview Manages, coordinates, facilitates and supports the members of the interdisciplinary team in provision of hospice care to patient/families of VNS Health Hospice Care Program, including After Hours. Ensures the implementation of clinical/quality improvement initiatives for hospice services in compliance with regulatory requirements. Demonstrates knowledge and commitment to excellence in clinical practice and customer service. Works under general direction. *This role includes a $15K sign-on bonus, payable in two installments during your first year of employment with VNS Health. • Ensures the use of an interdisciplinary approach to assess the medical, physical, social, emotional and spiritual needs of the patient. Ensures that support and direction to patient’s families are provided in accordance with the patient’s Interdisciplinary Plan of Care/Hospice Care mission, objectives, policies and procedures. • Participates in Hospice Team meetings, IDG management meetings, and serves on relevant committees for the purposes of information exchange, team collaboration, development of procedures and documentation tools, development of quality and training. • Ensures full regulatory compliance with Hospice Conditions of Participation and standards through review, monitoring and audit (ad hoc / regular) of files, processes and procedures. • Collaborates with Quality Improvement/Education in the development and implementation of quality improvement and educational activities to ensure professional practice standards are consistently met for each member of the team. Participates in the design, implementation, evaluation and modification of quality initiatives and educational plans. • Initiates, coordinates, performs and assists in the analysis of clinical, regulatory and fiscal practice. Assists leadership in achieving Hospice Care goals, objectives, and fiscal targets by providing support with compliance and/or innovation to achieve improvement. • Manages the day to day operations of the department, which includes effective caseload or visit management, achievement of productivity and revenue/expenditure targets for Hospice Care. • Completes all work assignments, which includes audits, reports and projects. • Performs all duties inherent in a managerial role. Ensures effective staff training, evaluates staff performance, provides input for the development of the department budget, and hires, promotes, and terminates staff and recommends salary actions as appropriate. • Facilitates and manages the interdisciplinary group for provision of an effective and comprehensive hospice services to patient/families of VNSNY Hospice Program. • Participates in special projects and performs other duties as assigned. Qualifications Licenses and Certifications: License and current registration to practice as a Registered Professional Nurse in New York State required Licensed and currently registered to practice as Nurse Practitioner in New York State and DEA license preferred Education: Bachelor's Degree in Nursing from an approved program accredited by the National League of Nursing or Health or Human Services field or the equivalent work experience required Work Experience: Minimum of three years clinical experience in hospice required Effective oral, written and interpersonal communication skills required Clinical management experience preferred Knowledge of personal computer operations, including MS Office applications preferred Pay Range USD $98,200.00 - USD $130,800.00 /Yr. About Us VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day. 
