Senior Care Manager-RN

Integrated Resources Inc.; New York (NY); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare organization is seeking a Care Manager to ensure continuity of care for newly enrolled members. The role involves developing care plans, conducting assessments, and managing community resources to facilitate member independence. The ideal candidate will possess clinical experience and strong communication skills, thrive in a fast-paced environment, and engage in both inbound and outbound telephonic communications.

Qualifications

• Minimum 2-3 years of clinical experience.
• Experience with MLTC, UAS assessment, and electronic documenting systems.
• Comfort in a fast-paced environment managing multiple priorities.

Responsibilities

• Assess and manage member needs, ensuring effective communication among all stakeholders.
• Develop and monitor Person Centered Service Plans.
• Facilitate care transitions and manage caseload effectively.

Skills

Clinical assessment

Care management

Communication

Bilingual (Spanish, Russian, Chinese)

Job description

Description:

Responsible for the assessment, reassessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care management. Regularly communicates with the members PCP and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning. Will be expected to coach and mentor less experienced Care Managers.

Qualifications

Requirements/Certifications:

• The candidate WILL HAVE at least have 2-3 years of clinical experience with a focus on MLTC,UASassessment experience, Major Medical and Surgical diagnosis experience and experience with electronic documenting systems.
• Experience with community resources, Behavioral health experience and bi-lingual (Spanish, Russian and or Chinese) are pluses. He/she MUST be comfortable in a fast pace environment andbe managingmultiple priorities.

Interview:

• The candidate will interview in-person with 2 clinical managers (1 interview with 2 managers).
• Clinical experience with a focus on MLTC, UAS assessment experience, Major Medical and Surgical diagnosis experience and experience with electronic documenting systems.

Additional Information

ESSENTIAL FUNCTIONS:

• Ensures continuity of care for newly enrolled members. Identifies and prioritizes the member’s needs and preferences. Develops quantifiable goals and desired outcomes, and promotes the members ability to self-manage to the greatest extent possible.
• Develops, implements and monitors the Person Centered Service Plan, assisting members in obtaining reasonable accommodations when appropriate. Manages case load, including risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings.
• Serves as the primary point of member contact. Assesses member needs, manages care and services, and ensures effective communication among members, caregivers, providers and community supports.
• As the leader of the interdisciplinary team facilitates the activities and communication within an interdisciplinary team of providers, vendors, facilities, discharge planners, field nurses, social workers, care coordinators, and member/caregivers to effectively manage care plans and transitions of care settings.
• Maintains timely, complete and accurate documentation using both hard copy and technology based solutions in compliance with regulatory policies and procedures. Gathers and summarizes data for reports. Supports initiatives of the Quality Assessment and Performance Improvement Committee. All other duties as assigned.

Additional Info:

• The selected candidate will manage about 120 members where the goal is to keep the member in the community by coordinating and managing the community-based resources that have been provided.
• This is a telephonic position with both inbound and outbound calls. The hours of operation are 9 am – 5 pm.
• The training will be about 2 weeks long that includes systems and expectations in the role. There is side-by side training and there is a buddy system set up for new Resources.