Hybrid Registered Nurse Care Manager - MLTC Queens/LI
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
Registered Nurse Care Manager
Builds
Patient-centered service plans and care coordination across hospital, sub-acute, long-term, and home settings
Domain
Healthcare / Long-term care / Managed care
Required skills
Registered Nurse licensure, care coordination, home visits, interdisciplinary collaboration, grievance handling, eligibility assessment, discharge planning, care management review, documentation, network provider utilization
Preferred skills
Bachelor's degree in Nursing, geriatrics experience, managed long-term care experience, multiple languages, Case Management Certification, bilingual skills
Technologies
Microsoft Office (Outlook, Word, Excel)
Responsibilities
Assess and monitor members' health needs and status; authorize covered services; collaborate with families, caregivers, and primary care practitioners; maintain independent living situations; assess eligibility for services; perform home visits; develop Patient Centered Service Plans; manage grievances and adverse determinations; conduct Care Management Reviews; document care management activities; ensure safe discharge plans.
Seniority
Mid-level, hands-on IC