Hybrid Registered Nurse Care Manager - Bronx
Core
Coordinate care for members across hospital, sub-acute, long-term, and home settings to promote independent living and quality cost-effective outcomes.
Role type
Registered Nurse Care Manager
Builds
Patient Centered Service Plans and care coordination across the health care continuum
Domain
Healthcare / Case Management
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
Perform in-home assessments and monitor member status; authorize covered services and coordinate care; collaborate with primary care practitioners and IDT to develop service plans; assess ongoing eligibility and document care management; identify complex care needs for Intensive Care management meetings; respond to grievances and complete Initial Adverse Determinations; ensure safe discharge plans; conduct home visits to assess living situations and functional needs.
Seniority
Mid-level, hands-on IC