RN Case Manager - MLTC

RCM Healthcare Services; New York (NY); Hybrid; USD 100,000 - 125,000; Full time

Job summary

RCM Healthcare Services is seeking a Registered Nurse Case Manager for MLTC with bilingual abilities preferred. This hybrid role includes 4 days remote and one day in the field, serving Long Island, Brooklyn, Queens, and Bronx locations.

Responsibilities include in-home assessments, care coordination across hospital to home settings, and collaboration with primary care physicians and IDT to create and implement Patient Centered Service Plans. Travel up to 25% may be required.

Qualifications

• Associate degree in nursing is required.
• Bachelor's degree in nursing preferred.
• Three years of RN experience required.
• Geriatrics/MLTC experience preferred.
• Bilingual skills highly preferred by territory needs.

Responsibilities

• Provide care coordination including in-home assessment, planning, facilitation, advocacy and authorization of services.
• Coordinate care across venues of care and with payers.
• Collaborate with PCP and IDT to develop Patient Centered Service Plan.
• Ensure safe discharge planning from the plan.

Skills

Effective communication

Regulatory knowledge

Advocacy

Critical thinking

Time management

Education

Associate nursing degree

Bachelor's in nursing preferred

Job description

RN Case Manager – MLTC (Bilingual Highly Preferred) – Hybrid (4 days remote)

Compensation and Benefits

Salary: $100,000 - $125,000

• Permanent, Full-Time Role

Location

• Current needs include:
  • Long Island
  • Brooklyn – Russian or Chinese speaking preferred
  • Queens – Bengali speaking preferred
  • Bronx – Chinese speaking preferred
• Up to 25% (regular) travel may be required to travel to different locations, including homes, offices, or other public settings, to perform work duties.

Position Summary

The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost-effective outcomes.

Schedule / Shift

• 4 days a week remote. 1 day a week in the field.
• Monday through Friday Business Hours

Key Duties

• Ensures consistent care along the entire health care continuum by assessing and closely monitoring members’ needs and status.
• Authorizes covered services and coordinates care regardless of payer.
• Assess, plans and provides continuous care management across all venues of care, including hospital, sub-acute, long-term and home settings.
• Collaborates with the primary care physician and Inter-Disciplinary Team (IDT) to develop the Patient Centered Service Plan for the member.
• Ensures appropriate, safe plan for members’ discharge from their plan.

Qualifications

• Associate’s degree in nursing from an accredited nursing program required
• Bachelor’s degree in nursing preferred
• Three (3) years of experience as a registered nurse required
• Clinical experience in geriatrics and/or managed long-term care experience preferred
• Bilingual language skills highly preferred based on territory and current operational needs

Licenses and Certification

• Current, unrestricted Registered Nurse licensure in the state of New York required
• Case Management Certification preferred

Skills

• Ability to communicate effectively with a diverse group of individuals
• Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
• Strong advocate for members at all levels of care
• Critical listening and thinking skills
• Strong organizational and time management skills

About Us

RCM Healthcare Services’ mission is to provide opportunities for qualified candidates across medical professions. We deliver timely results and have built a reputation of trust with our clients and candidates. Since 1975, we have been providing staffing solutions to many of the finest healthcare institutions across the nation and careers for thousands of candidates. As professional career opportunity matchmakers, we follow up and follow through to help our clients and candidates reach their career and life goals. We proudly hold the Joint Commission Gold Seal of Approval as well.

Equal Employment Opportunity & Reasonable Accommodation

RCM Technologies is an equal opportunity employer and values diversity. We are committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state laws. If you require a reasonable accommodation to apply for or perform this role, please contact us and we will engage in an interactive process to support your needs.