Care Management

Every MLTSS member has a Care Manager and Care Management team.

Your Care Manager is your team's leader and is a health care professional, generally a nurse or a social worker. The Care Management team includes a social worker and clinical support coordinator to help with your daily needs.

At the heart of your MLTSS program is your Care Plan, which you and your Care Management team developed so you can get the services you need. Your Care Management team helps coordinate your care – physician visits, prescription drugs, behavioral health, applying for services and coordinating other health providers.

Your Care Manager will call you at least once a month to check on you, and you will always have your Care Manager's phone number. You can call to talk to your care team or for help at any time. If you need help after work hours or on weekends, your call will go to someone who can help you right away.

You and your Care Management team will review your Care Plan at least every 90 days. The care team may also review your Care Plan if your condition or circumstances change. Horizon NJ Health members must use in-network, contracted providers to get covered MLTSS services.

Horizon NJ Health ensures that its MLTSS Care Managers work in a conflict-free environment. Care Managers cannot:

  • Work directly with members who are blood relatives
  • Work with members who are related by marriage
  • Cannot be a direct-paid caregiver to the member
  • Be financially responsible for, or empowered to make financial or health-related decisions on behalf of a member they are assigned to.

You can participate in your care by sharing your needs and concerns with your Care Management team so you may continue to live independently in your community.

You do have the right to change your Care Manager. You may do so by calling Member Services at 1-844-444-4410.