RN Care Manager

The RN Care Manager is responsible for completing comprehensive assessments to determine appropriate services and benefits for enrollees based on medical necessity. They provide plan education and coordinate transition to clinical services following Department of Health guidelines. The RN Care Manager advocates for enrollees, coordinates healthcare services, and ensures quality outcomes are met while adhering to all state and federal regulations including HIPAA. Identifies and coordinates enrollee services provided by the plan as well as services not covered by the plan. Completes comprehensive assessments using approved tools to determine eligibility for medically necessary services. Initiates and carries out continuous assessment of enrollees' needs and coordinates appropriate services. Observes enrollees for changes in condition and follows up with appropriate services or providers. Develops, monitors, and revises Plans of Care with enrollees. Implements orders for Durable Medical Equipment items and treatments as prescribed by physicians. Participates in marketing activities as requested and performs all duties in accordance with the Nurse Practice Act and professional nursing principles. Education/Experience Requirements Computer literacy, excellent communication skills, organizational and time management skills. Ability to work with patients/families in various settings and conditions. Valid New York State RN license, driver's license, and BLS Certification required, along with 1-2 years of experience in community-based care or healthcare. Disclaimer Qualified applicants will receive consideration without regard to age, race, religion, gender, sexual orientation, veteran status, or disability. Successful candidates might be required to undergo a background verification. Job Details Shift: Days, Hours: 7.50, Status: Full-Time, Pay Range: $30.00 - $38.92 Per Hour

Created: 2024-11-08