Hybrid Registered Nurse Care Manager - Queens - Mandarin Speaking Preferred! - 10K sign on Bonus!
Core
Coordinate care for members across the healthcare continuum (hospital, sub-acute, long-term, home) by assessing needs, authorizing services, and developing patient-centered service plans.
Role type
Registered Nurse Care Manager
Builds
Patient-centered service plans and care coordination for health plan members
Domain
Healthcare / Case Management
Required skills
Registered Nurse licensure, care coordination, home assessment, interdisciplinary collaboration, grievance investigation, discharge planning, eligibility assessment, cultural sensitivity
Preferred skills
Bachelor's degree in Nursing, geriatrics/long-term care experience, bilingual communication, Case Management Certification
Technologies
Microsoft Office (Outlook, Word, Excel)
Responsibilities
Perform home visits to assess living situations and functional needs; authorize covered services and coordinate care across all venues; collaborate with primary care practitioners and IDT to develop care plans; investigate and document grievances; identify members requiring Care Management Review; conduct initial adverse determinations; document care management notes (telephonic and in-person).
Seniority
Mid-level, hands-on IC