Care Manager, RN

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

📋 Description

• Design, evaluate, and implement comprehensive care management activities for members focusing primarily on physical health needs.

• Develop tailored care plans and offer educational support to members and their families.

• Assess member requirements, barriers to accessing care, and social determinants impacting health.

• Create continuous care/service plans and collaborate with healthcare providers, specialists, and community resources.

• Identify issues and obstacles to care and implement care management strategies.

• Coordinate with members, caregivers, and care provider teams to guarantee effective person-centered care.

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

• Adjust or refresh care plans in collaboration with members, caregivers, and providers as necessary.

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

• Ensure timely access to essential care and services.

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

• Gather, document, and uphold member information and care management activities to meet regulatory standards.

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

• Provide leadership insights on opportunities to enhance care and quality delivery in a cost-effective manner.

• Carry out other assigned responsibilities and adhere to organizational policies and standards.

⛳️ Requirements

• Current New Jersey Registered Nurse (RN) license is mandatory.

• Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing is required.

• 2–4 years of relevant experience is needed.

• RN state licensure and/or compact state licensure are essential.

• Capability to perform in-home member visits and undertake up to 50% local field travel.

• General availability from Monday to Friday, 8:00 AM to 5:00 PM EST, with flexibility based on member and business requirements.

• Proficiency in care management, healthcare coordination, member education, care plans, referrals, and understanding of healthcare benefits.

• Skill in documenting and maintaining member information in accordance with state, federal, and third-party payer regulations.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K plans available.

• Stock purchase plans offered.

• Tuition reimbursement support.

• Paid time off in addition to holidays.

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

• Additional incentive programs may be included in the overall compensation package.