RN Care Manager

RN Care Manager -ED

Job Location: New York, NY 10004

Job Duration: 3 Month (Possibility of extension)

Shift time: 9AM to 5PM, Hybrid

Pay: $65/hr. - $68/hr. on w2

Note: We have openings for Manhattan/Brooklyn/Bronx/Queens (choose any location, shift, department as per experience)

Position Overview

Role & Responsibilities:

• Ensure compliance with regulatory requirements and participate in the rotating on-call schedule.
• Document member contacts and care coordination activities within two business days.
• Coordinate with Utilization Management and Quality Management teams.
• Review additional service authorization requests and refer denials or reductions to the Medical Director when needed.
• Coordinate care transitions, discharge planning, and services across in-network and out-of-network providers.
• Assess member risks and identify clinical issues requiring timely intervention.
• Develop and monitor individualized care plans in coordination with members, physicians, nurses, and other providers.
• Review member assessments and UAS information for MLTC and MAP programs.

Skills

• Minimum of five (5) years of clinical experience as a Registered Nurse
• Leadership experience preferred
• Experience in: Care Coordination, Utilization Review, Discharge Planning
• Computer literacy required
• Bilingual Spanish Certification in Case Management

Education & Licensure

• Licensed Registered Nurse (RN) in the State of New York (required)
• Baccalaureate degree (required)
• PRI and Screen certification required within three (3) months of employment
• Preferred Qualifications: Master's Degree

Careers Integrated Resources Inc