Position Summary

Join our team and make a meaningful impact in the lives of members throughout Salem, Gloucester, Cumberland, and the surrounding counties. This is a work‑from‑home role with 50–75% local travel, Monday–Friday, 8:00 a.m.–5:00 p.m. EST.

We’re looking for a compassionate, mission‑driven nurse who thrives in the community—someone who is comfortable meeting members where they are, in any neighborhood, setting, or circumstance, to support their health and independence.

What You Will Do

As a Case Manager, you will help shape and deliver high‑quality care by developing, implementing, and supporting strategies that improve health outcomes for our members. You’ll apply clinical expertise and strong critical‑thinking skills to ensure members receive the physical, behavioral, and psychosocial services they need.

Your work will include care planning, collaborating directly with providers and interdisciplinary teams, coordinating services, and helping members navigate the resources that allow them to thrive. Strong assessment, writing, and communication skills are essential to success in this role.

Key Responsibilities

• Conduct in‑home, face‑to‑face visits using comprehensive assessment tools for members enrolled in:
  • Managed Long‑Term Services and Supports (MLTSS)
  • Dual Special Needs Programs (D‑SNP/FIDE)
• Complete assessments for non‑MLTSS members to evaluate medical needs and support requests such as:
  • Adult or pediatric medical day care
  • Personal care assistant services
  • Nursing facility custodial care
  • Personal Preference Program
  • MLTSS program enrollment
• Coordinate care with members, their authorized representatives, PCPs, and all care team participants.
• Schedule and participate in interdisciplinary team meetings.
• Advocate for members to ensure safe and appropriate transitions of care.
• Develop individualized care plans and authorize services in a cost‑effective manner.
• Document accurate and timely information in the electronic health record.
• Use sound clinical judgment and problem‑solving skills in daily decision‑making.
• Mentor new hires once proficiency is achieved.
• Successfully complete company‑sponsored NJ Choice Certification (required score of 80% or higher for continued employment).
• Member assignments may include pediatric populations and medically complex cases.

Required Qualifications

• Active, unrestricted RN license in New Jersey
• Comfort conducting field‑based home visits across all socioeconomic levels and community settings, including any neighborhood or environment, and with members in a wide range of living conditions or circumstances.
• 3+ years of clinical practice experience
• 3+ years of experience in home health, hospice, or a similar setting
• Residency in Salem County preferred
• Willing and able to travel 50–75% within assigned counties
• Successful completion of the NJ Choice Certification, including:
  • Minimum exam score of 80%
  • Completion of state training modules
  • Field mentoring component

Preferred Qualifications

• Case management and/or discharge planning experience
• Managed care experience
• Crisis intervention skills

Education

• Associate’s degree in Nursing (minimum requirement)