Care Specialist III – Field Based

NJM Insurance Group

Field-based Care Specialist managing healthcare services for members in New Jersey. Collaborating with healthcare teams and advocates for member needs.

Posted 7/14/2026full-timeHopewell • New Jersey • 🇺🇸 United StatesMid-LevelSenior💰 $70,500 - $94,395 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in case management and care coordination, ensuring high-quality, cost-effective healthcare services while advocating for members and families. Proficient in problem-solving, resource utilization, and compliance with clinical practice guidelines.

Highest-signal resume keywords

Case ManagementClinical ExperienceManaged Care IndustryOrganizational SkillsProblem Solving

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

AssessmentCare CoordinationResource UtilizationGoal Directed InterventionsDocumentation StandardsCaseload ManagementEligibility DeterminationCommunity Resource Location

Soft Skills

Effective CommunicationMember AdvocacyCollaboration

Industry Keywords

Health Care ServicesBehavioral ScienceHome CareDischarge PlanningQuality Improvement

About the role

Key responsibilities & impact

Accountable for the assessment and case management of members to ensure facilitation of health care services
Assist with implementation and facilitation of services to members in the program
Collaborates with member/family, physician and all members of the healthcare team, internal and external to this organization
Coordinates the delivery of high quality, cost-effective care based on the members' needs and the program model supported by clinical practice guidelines established by the plan
Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided
Utilizes the care management process to set priorities, plan, organize, and implement interventions that are goal directed
Encourages member participation and compliance in the case management program efforts
Utilizes program case management process for goal directed member/family care
Documents accurately and comprehensively based on the standards of practice and current organization policies
Interacts and communicates effectively with member during face to face and/or telephonic contact
Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes

Requirements

What you’ll need

Bachelor degree required in a health related or behavioral science field
Requires a minimum of three (3) to four (4) years broad clinical experience
Requires a minimum of three (3) years experience in home care, discharge planning, or case management
Requires a minimum of two (2) years' experience in the managed care industry
Requires strong knowledge of the standards of practice for care managers
Requires ability to interview and assess Members
Requires caseload management and casework practices
Requires human services principles for determining eligibility for benefits and services for their members
Requires the ability to effectively solve problems and locate community resources
Requires the needs and service delivery system for all populations in the Care Manager’s caseload
Requires strong organizational skills

Benefits

Comp & perks

Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement