Nurse Care Manager providing care coordination including assessments and planning for members' health needs in New York. Engaging interdisciplinary teams to ensure quality outcomes and member advocacy.
Responsibilities
The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost effective outcomes.
Ensures consistent care along the entire health care continuum by assessing and closely monitoring members’ needs and status.
Authorizes covered services and coordinates care regardless of payer.
Collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team.
Works with member/family to maintain the most independent living situation possible.
Performs home visits as required to assess members’ living situation, cultural influences, functional and cognitive needs.
Identifies same day grievances, investigates and documents accordingly.
Documents care management/coordination according to company policy.
Requirements
Associates degree in Nursing from an accredited nursing program required
Bachelor's degree in Nursing preferred
Three (3) years of experience as a registered nurse required
Clinical experience in geriatrics and/or managed long-term care experience preferred
Experience using multiple languages may be required based on operational needs
Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
Strong advocate for members at all levels of care
Bilingual speaking and writing skills are preferred.
Benefits
Health insurance
401(k) matching
Flexible work hours
Paid time off
Remote work options
Bonuses tied to company and individual performance
Manager of Commercial Training & Clinical Adoption designing training infrastructure for intraoperative imaging technology. Leading clinical adoption and training efforts for technology integration into surgical workflows.
After - Hours Care Manager & Scheduler overseeing operations and schedules for home care company. Critical role ensuring care delivery and problem - solving during after - hours shifts.
Service and Styling Manager at Anthropologie directing service and styling to inspire store environment. Leading a team to achieve sales metrics and implementing customer engagement strategies.
Integration Manager overseeing operations and project controls for construction projects at DPR Construction. Engaging in project execution planning and ensuring alignment with corporate strategies.
Responsible for managing varied supply chain processes within HP's large global business unit. The role enhances business processes and operational performance metrics while identifying optimization opportunities.
Lifecycle Management Manager overseeing supply chain and operations for multiple product lines at HP, ensuring operational excellence and alignment with organizational goals.
District Manager overseeing multiple Jared Jewelers locations providing leadership and support for store managers across Ohio, Pennsylvania, and New York. Established in jewelry retail, Jared is part of Signet Jewelers.
Sr. Engagement Manager leading account strategy for Fortune 1000 companies. Ensuring project success in digital transformation through effective management and partnerships.
Senior Manager in Enterprise Capital Management at Bank of America overseeing regulatory capital results and risk calculations. Building partnerships within ECM and managing financial resources for optimal capital management.