Care Manager – Nursing

This is a fully remote position, open to applicants in Alabama, +19 more states.

📋 Description

• Oversee the comprehensive care management and quality of care for participants.

• Evaluate assessments and discipline-specific documentation from field staff for quality assurance and address any deficiencies.

• Engage in care planning meetings and contribute as a member of the Interdisciplinary Team (IDT).

• Supervise field staff documentation and conduct coaching, competency assessments, and training sessions.

• Coordinate a continuum of care that aligns with the healthcare needs and goals of members.

• Organize, coordinate, and authorize member-specific services such as ADL/IADL assistance, housing, meals, and transportation.

• Execute care management activities and interventions aimed at achieving participant goals.

• Facilitate transitions between care settings in collaboration with team members, facilities, discharge planners, and home care coordinators.

• Record services in compliance with CLHC standards and federal/state regulations.

• Manage long-term care services in nursing homes, rehabilitation facilities, and other environments.

• Collaborate with primary care physicians (PCPs), specialty physicians, and the IDT regarding changes in participant conditions.

• Provide or arrange for skilled services, service authorization, periodic reassessment, and service evaluation.

• Monitor care management activities, services, member responses, the effectiveness of plans, and service utilization.

• Adjust care plans based on alterations in member health and objectives.

• Stay updated on health issues, procedures, evidence-based clinical guidelines, medications, and professional standards.

• Suggest enhancements to services, programs, policies, and procedures.

• Adhere to disciplinary policies and involve Human Resources as necessary.

• Operate strictly within the boundaries of the authority to practice.

• Complete all required position competencies prior to working independently.

• Commit to working from 8:00 AM to 5:00 PM, totaling 40 hours per week.

⛳️ Requirements

• Completed a Nursing education program recognized by the New York State Education Department (NYSED).

• A Bachelor's degree is preferred.

• At least two (2) years of experience in Care Planning is required.

• A minimum of two (2) years of administrative experience in a management role within a certified home health agency (CHHA), long-term home health care (LHCSA), acute care, medical-surgical, critical care, or nursing home settings is preferred.

• Customer Service experience is mandatory.

• Experience in managing long-term care insurance is advantageous.

• At least one (1) year of experience working with a frail or elderly population, or complete appropriate PACE organization training upon hiring if lacking this experience while meeting other requirements.

• Supervisory experience is preferred.

• A current active and unrestricted license and registration in New York State is required.

• Must be legally authorized to practice in the state where the healthcare professional will perform their duties.

• Must be medically cleared for communicable diseases and have all immunizations up-to-date before direct participant engagement.

• Bilingual candidates are preferred.

• Must meet the physical, cognitive, visual, auditory, mobility, lifting, and fine motor requirements of the position.

🏝️ Benefits

• Comprehensive health insurance options.

• Professional development and training opportunities.

• Competitive salary and performance-based incentives.

• Flexible work schedules.

• Retirement savings plans.

• Employee assistance programs.