RN Case Manager – MLTC

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

Job summary

RCM Health Care Services is seeking a bilingual RN Case Manager for MLTC in a hybrid role, combining field and remote work. The position involves coordinating care and advocating for cost-effective services to meet member needs.

Responsibilities include in-home assessment, service authorization, and collaboration with the primary care physician and IDT to develop a patient-centered plan. Travel up to 25% is anticipated.

Qualifications

• Associate degree in nursing required; bachelor’s preferred.
• Three years of RN experience; geriatrics or managed LTC preferred.
• Current NY RN license; case management certification preferred.

Responsibilities

• Provide in-home assessment, planning, and care coordination.
• Authorize services and coordinate care across settings.
• Collaborate with PCP and IDT to develop Patient Centered Service Plan.
• Support safe discharge planning and advocate for members.

Skills

Communication

Healthcare laws knowledge

Advocacy for members

Critical thinking

Time management

Education

ASN nursing degree

BSN preferred

RN 3+ years

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.

Responsibilities

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.


• Assesses, 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

Education and Experiences:

• 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.

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