MUST PERMANENTLY RESIDE IN NEW YORK - Please do not apply if you do not have a permanent residence in New York state and able to attend in person training in BAYSIDE QUEENS.
Bilingual English AND Russian or Chinese/Mandarin speaking ONLY
Position Title: Care Manager RN
Location: New York (Remote) (Must permanently reside in New York State)
Position Type: Full-Time
Reports To: Care Management Supervisor
KEY DETAILS: Virtual Orientation starts 11/17 for 2.5 weeks.
***Must be able to attend IN PERSON training for 10 days in Bayside Queens after orientation**
Position Summary: The Care Manager is responsible for coordinating and managing care services for members of a Managed Long-Term Care Service. This role involves working closely with patients, families, and healthcare providers to ensure that members receive comprehensive, individualized care that meets their long-term care needs. The Care Manager will use a holistic approach to assess, plan, implement, and evaluate care services, ensuring compliance with health plan policies and regulatory requirements.
Key Responsibilities:
- Conduct comprehensive assessments of members’ health, functional, and psychosocial needs to develop individualized care plans.
- Review and evaluate NY UAS information for members in the MLTC line of business.
- Coordinates and manages care services across multiple providers and settings, including home care, community resources, and healthcare facilities.
- Facilitate communication between members, families, and healthcare providers to ensure continuity of care and address any issues or barriers.
- Assesses and monitors the condition of the members via monthly calls.
- Identify clinical issues that require immediate attention to reduce the risk of unnecessary hospitalizations.
- Develop, implement, and regularly review care plans in collaboration with members, families, and multidisciplinary teams.
- Monitor and evaluate the effectiveness of care plans, adjusting as needed to meet changing member needs and goals.
- Timely and thorough documentation in the health record.
- Participates in weekly Interdisciplinary Care Team Meetings.
- Provide guidance and support to members and families on navigating the healthcare system and accessing appropriate services. Participates in family conferences, as needed. • Ensure care management activities comply with health plan policies, state and federal regulations, and accreditation standards.
- In collaboration with the Transition of Care Team, facilitates the discharge plan from the hospital or other alternate settings.
- Coordinates services in collaboration with the utilization management department
. • Track and report on care outcomes, quality metrics, and member satisfaction to identify areas for improvement and implement best practices.
- Conduct audits and reviews of care plans and services to ensure quality and compliance. • Identify and utilize community resources and services to support members' needs and enhance their quality of life.
- Advocate for members to access necessary services and benefits, including long term care services, medical equipment, and support services. • Manage and monitor care budgets and expenditures to ensure cost-effective use of resources.
- Provide education and support to members and families on disease management, care options, and self-care strategies.
- Offer training and guidance to other care team members on best practices in care management and coordination.
Qualifications:
- Education: Bachelor’s degree in nursing, master’s degree or advanced certification preferred.
• Bilingual preferred (ENGLISH and SPANISH) or English and Mandarin/Cantonese
- Licensure/Certification: Active & in good standing NYS RN license
- Experience: Minimum of 2 years of experience in case management, care coordination, or a related field, preferably in a managed care or long-term care setting, a plus
- Strong knowledge of long-term care services, healthcare systems, and regulatory requirements is a plus
- Excellent interpersonal, communication, and problem-solving skills.
- Proficiency in care management software, electronic health records (EHR), and other relevant technologies.
- Ability to work independently and as part of a multidisciplinary team. Work Location: • Remote Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to carry, lift, push or pull at least 20lbs
Job Type: Full-time
Benefits:
Application Question(s):
- Do you have an active RN license in New York?
- What language do you speak other than English?
- Do you have recent Care Manager experience?
Work Location: Remote