Hybrid Registered Nurse (RN) Care Manager - Manhattan - MLTC
Core
Coordinate care for members across hospital, sub-acute, long-term, and home settings to promote independent living and quality outcomes.
Role type
Registered Nurse Care Manager
Builds
Patient-centered service plans and care coordination for enrolled members
Domain
Healthcare / Long-term care / Geriatrics
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Registered Nurse licensure, care coordination, home assessment, interdisciplinary collaboration, grievance investigation, care management review, discharge planning, eligibility assessment, plan of care development
Preferred skills
Bachelor's degree in Nursing, geriatrics experience, managed long-term care experience, bilingual skills, Case Management Certification
Technologies
Microsoft Office (Outlook, Word, Excel)
Responsibilities
Conduct in-home assessments and monitor member status; authorize covered services and coordinate care across payers; collaborate with PCPs and IDT to develop service plans; manage grievances and adverse determinations; present complex cases at Intensive Care Management meetings; perform home visits to assess living situations and functional needs; document care management activities and recertifications.
Seniority
Mid-level, hands-on IC
