Nurse Case Manager II

Description

Job Title

Nurse Case Manager 2

Location

New York

Position Description

The Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license.

Roles Responsibilities

• Conduct telephonic visits using comprehensive assessment tools for members enrolled in Managed Long-Term Services and Supports (MLTSS). Perform in-person assessments for non-MLTSS members to determine medical needs and support appropriate service referrals.

• Work with diverse populations, including pediatric and medically complex members.

• Coordinate and collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams.

• Schedule and participate in interdisciplinary meetings, advocating for members to ensure safe transitions and appropriate services.

• Develop individualized care plans and authorize services within MLTSS/FIDE program benefits in a cost-effective manner.

• Document all assessments, interactions, and care planning activities accurately and in a timely manner in the electronic health record.

• Utilize strong critical-thinking and problem-solving skills in daily work.

• Mentor new staff once appropriate proficiency has been achieved.

Skills

• Active, unrestricted RN license in the state of New York.

• Minimum of 3 years of clinical experience in settings such as hospitals, home health, or ambulatory care.

• REQUIRED: MUST BE FLUENT IN ENGLISH/SPANISH (WRITING, READING, SPEAKING).

• Experience in case management and/or discharge planning.

• Background in managed care.

• Crisis intervention skills.

• Proficiency with computer skills, including navigating multiple systems and keyboarding.

• Effective communication skills, both verbal and written.

• Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment.

• Sedentary work involving periods of sitting, talking, listening, and typing on the computer.

• Work requires the ability to perform close inspection of hand-written and computer-generated documents as well as a PC monitor.

Education

• RN with current unrestricted state licensure.

• Case Management Certification CCM preferred.