Registered Nurse Case Manager - Field

About the role

This role involves serving as a Field/Remote Case Manager with up to 75% travel within designated counties. The primary responsibilities include conducting face-to-face member assessments, developing and implementing care plans, and coordinating services to promote member wellness, especially for medically complex and pediatric populations. The case manager collaborates with care teams, advocates for appropriate services, and ensures accurate documentation in electronic health records. Develop and support health service strategies, policies, and programs focused on utilization, quality, network, and coverage management. Conduct assessments, facilitate interdisciplinary meetings, and advocate for safe discharges and appropriate care. Manage member cases, including MLTSS and D-SNP programs, addressing service requests and enrollment needs. Coordinate care with providers, members, and caregivers, ensuring cost-effective utilization of resources. Maintain accurate, timely documentation and utilize critical thinking to solve problems. Mentor new hires and stay updated on healthcare practices.

Responsibilities

• Conducting face-to-face member assessments
• Developing and implementing care plans
• Coordinating services to promote member wellness, especially for medically complex and pediatric populations
• Collaborating with care teams
• Advocating for appropriate services
• Ensuring accurate documentation in electronic health records
• Developing and supporting health service strategies, policies, and programs focused on utilization, quality, network, and coverage management
• Facilitating interdisciplinary meetings
• Advocating for safe discharges and appropriate care
• Managing member cases, including MLTSS and D-SNP programs, addressing service requests and enrollment needs
• Coordinating care with providers, members, and caregivers, ensuring cost-effective utilization of resources
• Maintaining accurate, timely documentation and utilizing critical thinking to solve problems
• Mentoring new hires and staying updated on healthcare practices

Qualifications

• Active RN license in NJ
• Minimum of 3 years clinical experience
• Reliable transportation
• Successful completion of NJ Choice certification
• Preferably experienced in LTSS, case management, discharge planning, managed care, Medicaid, and Medicare
• Minimum associate’s degree in Nursing required

Skills

• Strong assessment, communication, and documentation skills
• Proficiency with MS Office, digital communication tools, and system navigation
• Ability to work independently and troubleshoot technical issues
• Work from home requires reliable internet, a dedicated workspace, and adherence to privacy standards

Benefits

• Medical
• Dental
• Vision
• Paid time off
• Retirement plans
• Wellness resources

Pay

Salary ranges from $66,575 to $142,576, depending on experience and location, with eligibility for bonuses and incentives.

Schedule

Full-time role with an expected 40 hours per week.