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Temporary Chronic Care Manager (Primary Care - Rural Health) na Bright Harbor Healthcare

Bright Harbor Healthcare · Bayville, Estados Unidos Da América · On-site

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Description

Position Title: Chronic Care Manager (Primary Care - Rural Health)
Position Type: Temporary Full Time; 35 Hours Weekly; this is a grant funded position available through October 31, 2026.  (Potential for Continuation)
Benefits Eligible: Yes
Location: Toms River, NJ
Department: Primary Care - Rural Health
Salary: $25.00 - $27.00 hourly

Responsibilities:

  • Develop, implement, and regularly update individualized care plans for patients with chronic conditions (e.g., diabetes, hypertension, COPD, heart disease).
  • Conduct comprehensive patient assessments, including medical, behavioral, and social determinants of health.
  • Provide ongoing care coordination, including scheduling follow-ups, managing referrals, and ensuring adherence to treatment plans.
  • Monitor patient progress through regular outreach (phone, telehealth, or in-person visits) and adjust care plans as needed.
  • Educate patients and caregivers on disease management, medication adherence, lifestyle changes, and preventive care.
  • Serve as a liaison between patients, primary care providers, specialists, hospitals, and community-based organizations.
  • Identify and address barriers to care, particularly those affecting rural populations (e.g., transportation, limited provider access, financial constraints).
  • Support transitions of care, including hospital discharge follow-ups and coordination with post-acute services.
  • Maintain accurate and timely documentation in the electronic health record (EHR) in compliance with regulatory and organizational standards.
  • Participate in quality improvement initiatives and population health management strategies.

Work Environment & Travel:

  • Combination of clinic-based work, remote care coordination, and occasional field visits.
  • Travel within rural regions of Ocean County New Jersey may be required.

Requirements

  • Bachelor’s degree in Nursing, Social Work, Public Health, or a related field preferred. 
  • Minimum of 2–3 years of experience in care management, chronic disease management, or primary care.
  • Strong understanding of chronic care models and population health principles.
  • Experience working with underserved or rural populations is preferred.
  • Excellent communication, organizational, and problem-solving skills.
  • Proficiency in EHR systems and care management platforms.
  • Ability to work independently and as part of a multidisciplinary team.

Preferred Skills:

  • Familiarity with telehealth tools and remote patient monitoring.
  • Knowledge of Ocean County NJ community resources and social service networks.

Benefits

  • Birthdays off
  • 12 Paid Holidays
  • Sick Days
  • Personal Days
  • Days Accrued Vacation
  • Medical/Dental/Vision
  • Company paid Life Insurance and Long-Term Disability
  • 403B Plan with Company Match
  • Opportunities for training/education/Continuing Education Credits
  • Opportunities for Public Loan Forgiveness
  • Opportunities for Tuition Discounts from Participating Institutions
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