RN Care Manager: Complex Care & Outcomes Lead

EmblemHealth; New York (NY); Remote; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth is seeking a Care Manager to provide comprehensive care management within a multi-disciplinary team. You will assess high- risk members, coordinate care plans, and support members in managing health care needs, benefits, and social determinants in their home or community settings.

The role requires an RN license in NY, 4–6+ years of clinical experience, strong communication skills, and experience with care coordination.

Qualifications

• RN license in NY required (active, unrestricted)
• 4–6+ years of clinical experience
• Experience in case management/care coordination, managed care, and/or utilization management (preferred)
• Strong communication skills (verbal, written, interpersonal)
• Familiarity with Motivational Interviewing (preferred)
• Proficient in MS Office (Word, Excel, PowerPoint, Outlook)
• Experience with electronic medical records (EMR) systems
• Bilingual ability (verbal and written) preferred

Responsibilities

• Assess and evaluate needs of the most complex members with a multidisciplinary team
• Identify goals, strategies and interventions and coordinate referrals
• Develop and evaluate medical management plans with member, family and providers
• Engage with PCPs/designees and other stakeholders
• Coordinate care plans and ensure timely, safe, effective, and patient-centered services
• Ensure compliance with federal/state regulations and NCQA standards
• Enter and maintain documentation in the EMR and meet timeframes

Skills

RN license NY

Clinical experience

Care coordination

Communication skills

Motivational Interviewing

MS Office

Bilingual (preferred)

Education

Bachelor's degree

Tools

EMR systems

Job description

EmblemHealth is seeking a Care Manager to provide comprehensive care management within a multi-disciplinary team. You will assess high- risk members, coordinate care plans, and support members in managing health care needs, benefits, and social determinants in their home or community settings.

The role requires an RN license in NY, 4–6+ years of clinical experience, strong communication skills, and experience with care coordination.