Part Time Insurance Nurse Reviewer Jobs (NOW HIRING)

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

Are you a nurse who is looking for a change? Do you feel overwhelmed and spread too thin in your current job? A return to the HOME could make you fall in love with nursing all over again! Focus on one patient at a time with Hackensack Meridian Health At Home. Our nurses spend valuable and meaningful 1:1 time with patients in their homes, where they feel most comfortable. Do what you do best, with a flexible schedule in a setting with fewer distractions. 

At Hackensack Meridian Health at Home, we recognize our full- and part-time benefit eligible team members by offering a Total Rewards package including comprehensive Health Benefits, generous Paid Time Off, Travel Reimbursement as well as an investment in your future with a 401(k) match and Tuition Reimbursement. Per Diem team members are eligible to participate in the 401(k) match and Travel Reimbursement. At www.TeamHMH.com,  you’ll find the information, resources and tools that will help you to be successful at HMH. From great benefits and innovative wellness programs, to robust learning and development opportunities, we continue to cultivate an exceptional work environment where you can do the kind of work that leads to fulfillment and professional growth.

Education, Knowledge, Skills and Abilities Required:

• Associate's Degree in Nursing or Diploma Certificate in Nursing
• At least six (6) months RN experience or at least 1 year of LPN experience, preferably in home care or hospice
• PC Experience/Skills

Education, Knowledge, Skills and Abilities Preferred:

• BSN

Licenses and Certifications Required:

• NJ State Professional Registered Nurse License.
• AHA Basic Health Care Life Support HCP Certification.

Responsible for providing professional nursing care to patients in their home through assessment, development, implementation and evaluation of home nursing care needs on an individual and continuous basis of assigned patients in accordance with organization policies and procedures and external regulations.

• Assure compliance with appropriate physician orders in a timely manner and that visit frequency follows physician orders. Assure documentation reflects compliance with physician's orders and addresses progression to goals being met at discharge.
• Assure that assessment, planning, intervention and evaluation of patient care follow policy, procedure, and standard of care. Demonstrate ability to care for a patient and significant other in a holistic manner. Assure safe patient care is provided. Demonstrate knowledge and competency in completion of assigned treatments and procedures according to established standards and policies. Utilize interdisciplinary team and accurately document all activities.
• Assure clinical judgments and critical thinking reflect professional standards of care and codes of ethics which provide for safe and effective patient outcomes. Appropriately document clinical decisions through appropriate system.
• Identify appropriate payors and remain in compliance with authorizations for self and other disciplines as necessary. Meet payor source guidelines. Maintain visit frequency with authorization range. Utilize secure messaging to insurance nurse for all authorizations.
• Assure documentation of assessment, interventions and planning meet organization time lines. Complete nursing assessment, medication reconciliation and collaborate with physician on Plan of Care. Update care plan within two week period of change in patient status.
• Implement specific teaching strategies to meet established goals on the plan of care. Assure documentation reflects appropriate teaching strategies in the medical chart that are consistent with goals and plans.
• Report patient care problems to manager or appropriate nursing management personnel and/or physician in a timely manner with possible solutions. Assure documentation indicates case communication. Appropriately utilize manager as a resource.
• Act as liaison among physician, Manager of Clinical Practice and other members of the health care team to ensure effective coordination and appropriate resource referrals. Assure that coordination of services is effective and meets client's needs.
• Communicate pertinent patient information and Plan of Care during transfers of patient care loads, either on a daily basis or whenever vacation days/time-off are scheduled.
• Complete routine assignments accurately, consistently and independently in a timely manner without the need for supervision. Meet productivity requirements on a consistent basis.
• Act as clinical supervisor of para-professional home health aide staff. Complete supervisory visits within regulatory time frame and assure visits are documented. Participate in the evaluation of home health aide staff.
• Maintain awareness of new/updated standards and incorporate these into nursing practice throughout continuum of care. Assure documentation in the medical chart demonstrates knowledge of current practices` guidelines.
• Other duties and/or projects as assigned. Demonstrate flexibility with job responsibilities in all areas.
• Adheres to HMH's Organizational competencies and standards of behavior.
• Lifts a minimum of 50 lbs., pushes and pulls a minimum of 50 lbs. and stands a minimum of 8 hours a day.

Minimum rate of $90,272.00 Annually
HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to:
Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness.
Experience: Years of relevant work experience.
Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
Skills: Demonstrated proficiency in relevant skills and competencies.
Geographic Location: Cost of living and market rates for the specific location.
Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization.
Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered.
Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts.
In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.