Remote Clinical Evaluation Manager

VNS Health; New York (NY); Hybrid; USD 85,000 - 106,300; Full time

Benefits offered by this job

Referral bonus opportunities

Generous paid time off (30 days)

Health insurance for family

Employer-matched retirement savings

Tuition reimbursement programs

Job summary

VNS Health is looking for a Clinical Case Manager in New York, NY to assess member needs and ensure high quality, cost-effective healthcare services. This position is mostly remote, requiring only brief in-office visits.

Qualified candidates will have at least two years of nursing experience, a clinical understanding of medical necessity, and expertise in Medicare/Medicaid policies. Comprehensive benefits include health insurance and generous paid time off.

Qualifications

• Minimum two years of case management experience in a healthcare setting.
• Knowledge of Medicare and Medicaid regulations is required.
• Must demonstrate the ability to work with LTSS eligible populations.

Responsibilities

• Conduct comprehensive reviews of service requests and clinical records.
• Ensure compliance with state and federal regulations.
• Coordinate transitions of care for members.

Skills

Organizational skills

Interpersonal skills

Effective communication

Microsoft Excel proficiency

Education

Associate's Degree in Nursing

Registered Professional Nurse license

Tools

Microsoft Word

Microsoft PowerPoint

Job description

VNS Health is looking for a Clinical Case Manager in New York, NY to assess member needs and ensure high quality, cost-effective healthcare services. This position is mostly remote, requiring only brief in-office visits.

Qualified candidates will have at least two years of nursing experience, a clinical understanding of medical necessity, and expertise in Medicare/Medicaid policies. Comprehensive benefits include health insurance and generous paid time off.