Senior Care Manager, RN

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

📋 Description

• Evaluate, strategize, and execute intricate care management initiatives for the NH Health Families Medicaid population.

• Create tailored care plans/service plans that cater to individual member needs.

• Inform members and their families/caregivers about available services, benefits, disease processes, care options, referrals, and healthcare instructions.

• Work in collaboration with providers, specialists, community resources, caregivers, and care teams to ensure coordinated, person-centered care.

• Track member status, changes in health conditions, progress, and care-plan objectives; adjust plans as necessary.

• Recognize obstacles and implement suitable care-management interventions for more complex cases.

• Analyze member data, referrals, and intake assessments to enhance quality, performance, and care plans.

• Conduct outreach through telephonic, digital, home visits, and/or other locations.

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

• Collaborate with leadership to enhance cost-effective care and quality service delivery.

• May mentor new clinical hires, provide coaching and shadowing, facilitate onboarding, and evaluate competency/readiness.

• Execute additional responsibilities as assigned while adhering to policies and standards.

⛳️ Requirements

• A degree from an accredited nursing program or a Bachelor's degree in Nursing.

• 4–6 years of relevant experience.

• RN state licensure and/or compact state licensure is required.

• NH RN licensure is mandatory.

• Experience in both Physical Health and Behavioral Health is highly preferred.

• Familiarity with care management, Medicaid services, healthcare benefits, referrals, and person-centered care.

• Capability to develop, monitor, and modify care plans/service plans.

• Proficiency in collaborating with members, caregivers, healthcare providers, specialists, community resources, leadership, and cross-functional teams.

• Competence in documenting care-management activities and adhering to state, federal, and third-party payer regulations.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K plans.

• Stock purchase options.

• Tuition reimbursement opportunities.

• Paid time off in addition to holidays.

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

• Potential additional incentive programs.

• Commitment to equal opportunity employment.