Care Manager, RN

Care Manager, RN

Location:

New Castle County (Hybrid)

Duration: 3 months (Possibility CTH)

Base pay range: $46.42/hr - $49.09/hr

Candidate must be located within New Castle County. The Care Manager drives to visit members 3 days a week, and works from home the remaining 2 days. Face‑to‑face visits are required, with a willingness to begin visits in week 1. Candidates must complete the "Care Manager" assessment in Glider.

This role works directly with providers across a variety of health‑care settings—including physician offices, hospital environments, and members’ homes—to identify individuals with chronic conditions or gaps in care. The incumbent helps high‑risk members coordinate care and navigate the healthcare system by recommending and implementing interventions that improve medical care quality and reduce costs.

• Travel to members’ homes, nursing facilities, and community based settings to conduct face‑to‑face needs assessments, followed by telephonic contact in accordance with state and national guidelines.
• Assess, plan, coordinate, implement, and evaluate care for eligible members with chronic, complex health, social service, and custodial needs.
• Coordinate care across the continuum of services, supporting members’ physical, behavioral, long‑term services and supports (LTSS), social, and psychosocial needs in the safest, least restrictive manner while ensuring cost‑effectiveness.
• Facilitate authorization, coordination, continuity, and appropriateness of care and services in community or HCBS settings.
• Coordinate transitions to alternate care settings (e.g., hospital to home, nursing facility to community) using an integrated care team.
• Educate members or caregivers regarding health‑care needs, available benefits, resources, and services.
• Provide education, resources, and assistance to help members achieve goals outlined in their plan of care.
• Develop a plan of care with members or caregivers, identifying services needed to meet specific goals.
• Identify resources for a fully integrated care coordination approach, including referrals to disease/chronic condition management, behavioral health, and complex case management programs.
• Collaborate with the member’s health‑care and service delivery team to maintain the member in the least restrictive safe environment possible; assist in developing backup plans for gaps in provider coverage.
• Ensure approved support services are executed as outlined in the plan of care and evaluate effectiveness, revising as needed per policy and contractual requirements.
• Document all case‑management services and interventions in the electronic health record, complying with all privacy, HIPAA, and quality performance standards.
• Perform other duties as assigned or requested.

• Registered Nurse with at least 2 years of experience in long‑term care, home health, hospice, public health, or assisted living.
• One year of home clinical or case‑management experience.
• Experience with Medicare, Medicaid, and managed‑care programs.
• Flexible scheduling to meet member needs.
• Proficiency in PC‑based word processing and database documentation (Word, Excel, Outlook).
• Reliable transportation for daily travel within the assigned territory.
• Ability to meet regulatory deadlines.
• Dedicated home workspace compliant with telecommuter policies.
• Experience with geriatric special needs and behavioral health.
• Cultural competency in addressing targeted populations.
• Experience with electronic documentation systems.
• Knowledge of cost neutrality and budgeting.
• Willingness to travel throughout the state as required.
• Strong verbal communication skills for member assessments over the phone.
• Strong organizational skills.

Mid‑Senior level

Contract

Health Care Provider