Remote Care Manager RN – Pediatrics (NY, CT, NJ licensure)

Job Title: Care Manager RN – Pediatrics (NY, CT, NJ license required)

Summary of Position:

The Pediatric Care Manager RN is responsible for providing care management for children and adolescents as part of a multidisciplinary team. This includes coordinating care, conducting telephonic and face-to-face assessments, identifying gaps in pediatric care, and implementing interventions to support members’ physical, developmental, environmental, and psychosocial needs. The Care Manager RN works closely with providers, caregivers, and community resources to promote safe, effective, and child-centered care.

Key Responsibilities:

· Assess and evaluate the needs of pediatric members, collaborating with caregivers, pediatric providers, and community resources to address medical, developmental, and psychosocial concerns.

· Develop individualized care plans with clear goals and interventions tailored to children and families, including referrals, education, and activation of support resources.

· Coordinate safe and timely transitions of care, including hospital discharge and specialty care, ensuring pediatric members receive appropriate care in the right setting.

· Engage families, caregivers, and primary care providers in setting and achieving care goals that improve health outcomes, developmental milestones, and quality of life.

· Collaborate with interdisciplinary team members such as dietitians, social workers, child life specialists, and community health workers to deliver holistic pediatric care.

· Act as an advocate and liaison for pediatric members and families, connecting them with providers, community programs, and governmental resources.

· Ensure compliance with federal, state, NCQA, and organizational standards in all pediatric care management processes.

· Document all activities in the electronic medical record system accurately and within required timeframes.

· Participate in case conferences, committee work, and training as assigned.

· Monitor and evaluate pediatric members’ progress, updating care plans as needed.

· Support population health, transitions of care, and complex pediatric case management initiatives.

Qualifications:

Education, Training, Licenses, Certifications

· Bachelor’s degree in Nursing required.

· Current, active Compact & New York RN license.

· Pediatric CCM certification preferred.

· Certification in utilization or care management preferred.

Experience, Knowledge, Skills, Abilities

· 4–6 years of clinical experience, preferably in pediatrics.

· Background in case management, care coordination, managed care, or utilization management.

· Strong organizational and prioritization skills; ability to manage a caseload of highly complex pediatric members.

· Proficiency in motivational interviewing techniques.

· Experience with electronic medical records and MS Office applications.

· Strong communication and interpersonal skills, with the ability to engage children and families effectively.

· Bilingual abilities strongly preferred.

· Ability to collaborate across teams and problem-solve effectively.

· Flexibility to work evenings as needed to support pediatric member needs.

We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws

Pay: From $98,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance

Application Question(s):

• I have case management experience in PEDs.
• I can work a remote EST work schedule.
• I am available to work one evening shift a week.
• I have my compact RN license.
• I have my New York RN license (standalone state).

Work Location: Remote