Care Manager, RN

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Design, evaluate, and implement complex care management strategies for members primarily with physical health requirements.

• Assess member needs, obstacles to accessing care, and social determinants impacting health.

• Create and maintain ongoing care plans and service strategies.

• Work collaboratively with healthcare providers, specialists, community resources, members, families, and caregivers.

• Detect issues and barriers to care, providing suitable interventions.

• Coordinate individualized care and services.

• Monitor and follow up on member status, changes in condition, and progress towards care plan objectives.

• Offer local resource support for services including employment, housing, participant direction, independent living, justice, and foster care.

• Ensure timely access to necessary care and services.

• Conduct outreach through telephonic, digital, home, and various other site visits.

• Gather, document, and uphold member information and care management activities to ensure regulatory compliance.

• Educate members and their families/caregivers about disease processes, care gaps, provider instructions, care alternatives, referrals, and healthcare benefits.

• Provide leadership feedback regarding opportunities to enhance care quality and cost-effectiveness.

• Complete other assigned tasks and adhere to organizational policies and standards.

⛳️ Requirements

• Degree from an accredited School of Nursing or a Bachelor's degree in Nursing.

• 2–4 years of relevant experience.

• Active RN license in New Jersey.

• RN - Registered Nurse - State Licensure and/or Compact State Licensure is mandatory.

• Proficient computer skills.

• Excellent time-management abilities.

• Strong organizational skills.

• Capability to manage an MLTSS caseload in alignment with New Jersey Medicaid regulations.

• Comfort in a fast-paced work environment.

• Willingness to travel approximately 50% for member visits.

• Availability Monday through Friday from 8:00 a.m. to 5:00 p.m., with flexibility based on business needs.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement support.

• Paid time off along with holiday pay.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional incentive options may be included in total compensation.

• Equal opportunity employer dedicated to promoting diversity.