Case Management Nurse

Pride Health; New York (NY); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Healthcare coverage

Supplemental coverage

401(k) plan

Life & disability insurance

Employee assistance program

Legal support

Insurance discounts

Job summary

Pride-Health is seeking an experienced Registered Nurse for a non-patient-facing Care Manager position in New York. The RN will focus on care coordination, utilization management, discharge planning, and case management while collaborating with interdisciplinary teams, members, and caregivers to develop and manage individualized care plans. Location: New York, NY 10004.

Schedule: Monday–Friday, 9:00 AM – 5:00 PM (35 hours/week). Duration: 8–13+ weeks with potential extension.

Qualifications

• Active New York RN License
• BSN required
• Minimum 5 years of clinical nursing experience
• Experience in Care Coordination, Utilization Review, and Discharge Planning
• MLTC experience required
• Computer proficiency required
• PRI and Screen Certification required within 3 months of hire

Responsibilities

• Coordinate and manage member care plans.
• Perform utilization review and discharge planning.
• Collaborate with providers and interdisciplinary teams.
• Assess member needs and coordinate appropriate services.
• Maintain accurate documentation and ensure compliance with regulatory guidelines.
• Support quality improvement and care management initiatives

Skills

RN License NY

Care Coordination

Utilization Review

Discharge Planning

Care Management

Regulatory Compliance

Computer Proficiency

PRI Certification

Education

BSN

Job description

Care Manager (RN) – Non-Patient-Facing - MLTC

Location: New York, NY 10004

Schedule: Monday–Friday | 9:00 AM – 5:00 PM (35 hours/week)

Duration: 8–13+ weeks (extension possible)

Pay Rate: $58–$61/hour ( Based on Experience)

We are seeking an experienced Registered Nurse (RN) for a non-patient-facing Care Manager position in New York. This role is focused on care coordination, utilization management, discharge planning, and case management. The RN will collaborate with interdisciplinary teams, members, and caregivers to develop and manage individualized care plans while ensuring appropriate utilization of healthcare services and improved member outcomes.

Responsibilities:

• Coordinate and manage member care plans.
• Perform utilization review and discharge planning.
• Collaborate with providers and interdisciplinary teams.
• Assess member needs and coordinate appropriate services.
• Maintain accurate documentation and ensure compliance with regulatory guidelines.
• Support quality improvement and care management initiatives.

Qualifications:

• Active New York RN License
• BSN required
• Minimum 5 years of clinical nursing experience
• Experience in Care Coordination, Utilization Review, and Discharge Planning
• MLTC experience required
• Computer proficiency required
• PRI and Screen Certification required within 3 months of hire

Pride-Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Pride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations

We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates:

Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation