Nurse Case Manager III

Job Responsibilities:

• The care manager is responsible for assessing and evaluating members with potential care management needs through telephonic and face to face assessments in various settings, including the member’s private residence, hospitals, behavioral, and long-term nursing facilities. The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers. The care manager monitors and evaluates the effectiveness of the care plans and adjusts the care plan based on clinical judgement and member needs. Care managers coordinate and collaborate with members, authorized representatives, primary care providers, and other care team participants to coordinate services and ensure timely service delivery. The care manager will take an interdisciplinary approach to advocate for members’ needs to ensure a safe discharge post hospitalization or transition from a nursing facility, including addressing social needs (e.g., housing and food insecurity). Accurate and timely documentation in the member’s electronic health record is essential. The care manager role requires critical thinking, problem-solving skills, and the ability to work autonomously. Additionally, the care manager may be asked to mentor new hires once proficient in the role.

Skills:

• Bilingual preferred (Spanish)
• 3+ years’ work experience in pediatric, Special Needs and/or Adult Population
• RN with current unrestricted state licensure in the State of New Jersey
• Registered Nurse (RN) licensure required.
• Reliable transportation required to complete F2F visits (Mileage is reimbursed by our company expense reimbursement policy)
• Computer literacy and demonstrated proficiency to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.
• Working knowledge of medical terminology.
• Working knowledge of digital literacy skills.
• CCM (Certified Case Manager)

Education/Experience:

• Associate and RN with current unrestricted state licensure in the State of New Jersey