About this role

Conduct in-home, face-to-face assessments for members enrolled in: Managed Long-Term Services and Supports (MLTSS) Dual Special Needs Programs (D-SNP/FIDE)
Evaluate member needs and coordinate services such as: Adult/pediatric medical day care Personal care assistant services Nursing facility placement MLTSS program enrollment
Partner with members, caregivers, PCPs, and interdisciplinary teams to develop and implement individualized care plans.
Authorize services in alignment with program guidelines and support safe transitions of care.
Document all case activity accurately and promptly in the electronic health record.
Apply strong clinical judgment and critical thinking to manage complex care needs.
Mentor new team members once proficiency is achieved.

Active, unrestricted RN license in New Jersey
3+ years of clinical practice experience
3+ years of experience in home health, hospice, or a similar setting
Ability to manage pediatric and medically complex cases
Residency in Passaic County NJ
Successful completion of the NJ Choice Certification, including: o Minimum exam score of 80% o Completion of state training modules o Field mentoring component
Must possess reliable transportation and be willing and able to travel up to 75% of the time.

Registered Nurse Case Manager – LTSS

Key skills