Registered Nurse, Care Manager

This is a fully remote position, open to applicants in New York.

📋 Description

• Deliver care management services to a designated group of health plan members.

• Develop Person-Centered Service Plans (PCSP) tailored to individual needs.

• Coordinate services and maintain documentation in accordance with health plan standards.

• Assess, plan, facilitate, and advocate for member support and services using an interdisciplinary approach.

• Execute quality and cost-effective care plans by leveraging available resources and UAS-NY assessments.

• Collaborate with members, families, healthcare teams, medical professionals, and community-based programs.

• Manage a caseload of members within a managed care framework.

• Complete necessary regulatory documentation in a clear, concise, and timely manner.

• Coordinate support staff for the health plan, which includes LPNs, Community Health Workers, and Care Coordination personnel.

• Offer guidance and education to support staff to enhance service delivery.

• Engage in departmental, staff, and training meetings actively.

• Adhere to state and federal privacy regulations, including HIPAA compliance.

• Communicate effectively and collaborate with members, families, health plan staff, and healthcare providers.

• Act as a liaison and advocate for members’ needs.

• Exhibit cultural competency and address members' cultural health beliefs, language preferences, and support systems.

• Perform additional duties as assigned.

⛳️ Requirements

• Must possess a current license and registration as a Registered Professional Nurse in New York State.

• An Associate degree is required.

• At least one year of nursing experience is mandatory.

• Experience in long-term care and/or managed care is advantageous.

• Familiarity with homecare, Medicare, and Medicaid is beneficial.

• Care Management Certification is a plus.

• Bilingual capabilities are a plus.

• Ability to work autonomously and effectively prioritize workload is essential.

• Proficient computer skills, including familiarity with Microsoft Office programs.

• Strong communication skills are required, both face-to-face, virtually, and over the phone.

• A valid NYS driver's license and the ability to drive in various weather conditions are necessary.

• Capacity to learn and regularly utilize the organization's software systems.

• Ability to perform duties that may involve exposure or potential exposure to blood, body fluids, or tissues.

• Physical capability to meet requirements, including frequent lifting of up to 20 pounds and occasional lifting of up to 50 pounds.

🏝️ Benefits

• Up to a $15,000 sign-on bonus.

• Eligible site for the Nurse Corps Loan Repayment Program.

• Retention bonuses available.

• 401k plan with a generous employer match.

• Comprehensive medical, dental, and vision plans.

• Tuition reimbursement for BSN after 6 months of employment.

• Excellent work/life balance with no rotating shifts, holidays, or weekends.

• Partially funded Health Savings Account (HSA).

• Employee recognition platform.

• Paid time off, holidays, and extended sick leave.

• Short and long-term disability coverage.

• Employee Assistance Program (EAP).

• Remote-first work environment.

• Flexibility to maintain work-life balance.

• Occasional in-person training or team events held a few times per year.