Registered Nurse, Care Manager

Role Overview

• Provides care management for members through an interdisciplinary approach through assessment, planning, facilitation, and advocacy for support and services to meet a member's needs.
• Implements an appropriate, quality, and cost-effective plan of care that utilizes all resources available to meet the members needs in collaboration with the member, family, health care team, medical providers, and other community-based programs based on the UAS-NY assessment.
• Oversees caseload of managed care members.
• Performs all care management activities in compliance with all regulatory agency requirements; completes required documentation, that is clear and concise and is done in a timely manner (organizational standards).
• Responsible for coordination of health plan support staff, including LPN, Community Health Workers, and Care Coordination; provide guidance and education to efficiently manage patients using a team approach.
• Participate in departmental meetings and attend all scheduled staff meetings and training as applicable and required.
• Adhere to all state and federal privacy regulations, including HIPAA and Nascentia Health Options policies and agreements regarding confidentiality, privacy, and security.
• Communicate and collaborate effectively with potential members, their families, health plan staff, and providers.
• Acts as a liaison and member advocate.
• Demonstrates cultural competence by respecting and being responsible for the member's cultural health beliefs, language needs, and support system.
• Other duties as assigned.

Requirements

• Nursing: License and current registration as a Registered Professional Nurse in New York State.
• Education: BSN preferred; associate degree required.
• Minimum of one year of Nursing Experience is required.
• Long-term care and/or managed care experience a plus
• Knowledge of homecare, Medicare, and Medicaid is a plus.
• Care Management Certification is a plus.
• Bilingual skills a plus
• Ability to work independently and prioritize workload.
• Computer literate and working knowledge of basic computer skills and Microsoft Office programs.
• Strong communication skills, both person-to-person, virtually, and by phone.
• Valid NYS drivers license and ability to drive in all types of weather to visit plan members in their homes.
• Ability to learn and routinely utilize the organizations software systems to perform required job duties.

Benefits

• Competitive Salary
• $15,000 sign-on bonus*
• Retention bonuses
• 401k with generous Employer match
• Medical, Dental, Vision plans
• Tuition Reimbursement for BSN after 6 months of employment
• Exceptional work/life balance
• no rotating shifts, holidays or weekends
• Partially funded HSA
• Employee Recognition Platform
• Paid Time Off, Holidays, and Extended Sick Leave
• Short/Long term Disability
• Employee Assistance Program (EAP)
• Much More!