• Develop a housing strategy for Horizon membership (specifically MLTSS/SNP/Medicaid) • Identify and manage resources for housing options • Provide education to all relevant staff, Care Management, Member Advocates and Utilization Management on housing options and resources. • Assist with locating and placing members in appropriate housing, facilitating transitions to community settings. • Complete reports to meet the state requirements; including but not limited to progress towards goals, quality monitoring. • Act as a liaison with DMAHS staff or its designee to receive training and capacity building assistance. • Must work closely with relevant public and private housing resources and stakeholders, including but not limited to HUD subsidized housing, all Department of Community Affairs (DCA), New Jersey Housing and Mortgage Finance Agency (NJ HMFA) housing program voucher programs, public housing authorities, realtors, and online housing locator resources.

• conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse • Handle high profile or highly sensitive matters involving cases that are national in scope • Investigate matters of program integrity to prevent payment of aberrant claims • Conduct thorough research on subject(s) and related entities • Initiate proactively data mining using SIU Tools to identify aberrant billing patterns • Conduct extensive analysis of claims data to determine aberrancy, pattern, or scheme • Research and prepare cases for clinical and legal review • Accurately document all case activity and communications in designated case tracking system • Communicate clinical findings to provider • Facilitate case outcomes for the recovery of company and customer monies lost from aberrant billing

• Conduct the annual Health Risk Survey to support needs identification for the member’s Individual Plan of Care • Inform the assigned care manager of newly identified health/safety risks or service needs • Complete care coordination activities delegated by the care manager within an established timeframe • Inform the assigned care manager and/or associate manager of any identified quality of care issues • Passionately support the member’s care coordination needs and drive solutions to address those needs • Use problem-solving skills to find alternative contact information for members who are unreachable by care management • Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health • Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies

• Engage with members and coordinate their care for 50-75% of the day • Utilize resources to connect with 'hard-to-reach' members • Develop individualized care plans with members • Maintain meticulous documentation of care management activities • Work with the Interdisciplinary Care Team to address barriers to care • Identify and connect members with health plan benefits and community resources • Meet regulatory requirements within specified timelines