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RN Care Manager

Posted: September 16, 2024
Salary:US$48 - US$52 per hour + PTO, Health, Dental, Vision, 401k
Location:New York
Job type: Permanent
Discipline:Care Management
Reference:233452_1726516007
Work Location:Remote

Job description

REMOTE Clinical Care Manager (RN)

**Must be licensed in NY state and commutable to NYC**

Job Overview:

We are seeking dedicated Registered Nurses (RNs) to join our team, specializing in Medicaid care management. Our mission is to deliver personalized, evidence-based care that empowers patients to manage their health safely within their homes and communities. As a Clinical Care Manager, you will play a crucial role in coordinating healthcare benefits and services, ensuring high-quality, cost-effective care for a diverse patient population.

Key Responsibilities:

  • Coordinate and oversee benefits and services for all members on your caseload.
  • Complete care management and disease-specific assessments.
  • Conduct timely telephonic care management calls based on risk levels.
  • Resolve complex issues and member complaints related to service delivery.
  • Provide health education to members and caregivers.
  • Assess Social Determinants of Health (SDoH) and coordinate care to reduce barriers.
  • Identify and address member safety issues, referring to appropriate resources when necessary.
  • Advocate for members/caregivers to optimize their quality of life.
  • Promote adherence to physician treatment plans through education, coaching, and support.
  • Increase utilization of primary care, specialty care, preventive health, and guideline-based treatments.
  • Participate in interdisciplinary team (IDT) meetings, providing input on customer service-related activities.
  • Protect the confidentiality of member information and ensure compliance with company policies and regulations.

Qualifications:

  • Associate degree in nursing or a bachelor's degree in nursing required.
  • Minimum two years of experience as a registered nurse.
  • Active and current license as a Registered Professional Nurse in the State of New York.
  • Population Care Coordination Certification preferred.
  • Care Management, Case Management, OASIS, or other application certification preferred.

Preferred Background:

  • Experience with patients diagnosed with HIV, or familiarity with HIV care.
  • Experience in care management, especially within Medicaid.
  • Experience in transgender care or mainstream/traditional Medicaid.
  • Spanish bilingual skills are highly desirable.

Caseload:

  • Manage a caseload of approximately 250 members, with a CMSC partner. Outreach calls will be rotated monthly, with flexibility for clinical needs.

Work Environment:

  • Primarily remote, with potential in-office requirements up to 6 times a year (subject to increase). Flexibility is expected.

Join us in making a meaningful impact in the lives of our patients, helping them navigate their healthcare journey with confidence and support. Apply today to become a part of our dedicated team! #medixeast