Care Manager - RN

Registered Nurse Care ManagerWe are seeking an experienced Registered Nurse Care Manager to support care coordination for members enrolled in managed long-term care programs. This role is ideal for an RN with strong experience in care management, utilization review, discharge planning, and community-based healthcare.Key ResponsibilitiesReview member assessments and UAS information for MLTC and MAP programs.Develop comprehensive, individualized care plans based on member needs and identified risks.Collaborate with primary care physicians, nurses, caregivers, and other healthcare providers.Monitor member conditions and identify issues requiring timely clinical intervention.Coordinate services across the continuum of care, including transitions and discharge planning.Help reduce unnecessary hospitalizations, emergency department visits, and nursing home admissions.Partner with Utilization Management on concurrent and retrospective reviews.Ensure members receive appropriate preventive and chronic disease care.Maintain timely and accurate care management documentation.Participate in interdisciplinary care planning and a rotating on-call schedule.Ensure care management activities meet applicable MLTC/MAP regulatory requirements.Key QualificationsActive New York State Registered Nurse license required.Bachelor's degree required; BSN preferred.Minimum 5 years of clinical RN experience.2 to 3 years of experience in CHHA, Lombardi, MLTC and/or MAP programs.Experience with care coordination, utilization review, and discharge planning.PRI and Screen certification required within three months of employment.Strong computer and clinical documentation skills.Leadership experience preferred.Master's degree, Case Management certification, and bilingual Spanish skills are preferred.