New Jersey-RN Case Manager
$93,600–$124,800 year
HybridJersey City, New Jersey, United States or Atlantic City, New Jersey, United States
Job Summary
Conduct comprehensive telephonic and in-home assessments for Medicaid members with complex chronic conditions, developing individualized care plans that integrate medical, behavioral, and social support services. Administer infusion therapies and acute pain management in community settings, including IV line placements and vital sign monitoring, while utilizing remote patient monitoring tools to track high-utilizer triggers. Coordinate care transitions with interdisciplinary teams and primary care providers to reduce hospital readmissions, ensuring all documentation meets NCQA, HEDIS, and CMS regulatory standards. This hybrid role requires active travel across multiple states for home visits and infusion services, with a focus on health equity and culturally competent care delivery.
Required Qualifications
- Bachelor's degree in nursing (BSN) or equivalent
- Active multistate Registered Nurse (RN) license in all state(s) of practice
- CPR/BLS certification
- Minimum 2+ years of clinical nursing experience in relevant settings such as care management, population health, acute care, infusion therapy, hematology, pain management, or community health
- Active driver's license
- Willingness to travel to patient homes across assigned regions
- Commitment to health equity and delivery of culturally competent care in diverse communities
Desired Qualifications
- Experience serving Medicaid or complex care populations
- Knowledge of Long-Term Support Services
- Certified Case Manager (CCM)
- Additional specialty certifications such as ACLS (Advanced Cardiac Life Support), ONCC (Oncology Nursing), or CRNI (Certified Registered Nurse Infusion)
- Expertise with electronic health record systems and remote patient monitoring technology
- Bilingual proficiency
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