Hybrid BH Nurse Care Manager - MLTC - Brooklyn
Core
Coordinate care for members across the health care continuum, including in-home assessments, planning, and advocacy to promote quality, cost-effective outcomes.
Role type
Senior Registered Nurse Care Manager (MLTC)
Builds
Patient-centered service plans and care coordination for members in hospital, sub-acute, long-term, and home settings
Domain
Long-term care and managed long-term care (MLTC)
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Registered Nurse licensure, care coordination, home visit assessment, interdisciplinary collaboration, grievance investigation, care management review, discharge planning, eligibility assessment
Preferred skills
Bachelor's degree in Nursing, geriatrics experience, managed long-term care experience, bilingual communication, Case Management Certification
Technologies
Microsoft Office (Outlook, Word, Excel)
Responsibilities
Assess and monitor members' health needs and status; authorize covered services; collaborate with families and primary care practitioners; perform home visits to assess living situations; develop Patient Centered Service Plans; manage grievances and adverse determinations; conduct Care Management Reviews; document care coordination and recertification notes.
Seniority
Senior, hands-on IC
