(Archived) RN Care Manager

JOB TITLE (#2314): RN Care Manager - New York, NY

An established insurance company with locations throughout New York is seeking an RN Care Manager to join its growing team. This company provides the highest quality healthcare services to residents of the Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a comprehensive list of products. They have been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Compensation and Benefits:

• The salary range for this position is $96,682 / yr
• This is a Full-time position
• Health Insurance Plans
• Flexible Spending Account Programs
• Management or Union Benefits
• Leaves Benefits
• Special Leave of Absence Coverage (SLOAC)
• Retirement Savings Plans
• Additional Savings Plan
• Transit Benefit
• Direct Deposits
• Municipal Credit Union (MCU)

Requirements:

• Must have Bachelor’s Degree in Nursing
• Must have a current NYS Registered Nurse license
• Must have a minimum of 2 years prior experience in a health care setting, Care Management, or Managed Care setting
• Must have the ability to proficiently read and interpret medical records, claims data, pharmacy, lab reports, and prescriptions
• Must have the ability to work closely with members and caregivers
• If needed, the ability to travel within the company’s service area to participate in facility visits, community events, home visits, or other community meetings, including conferences.

Responsibilities:

• Address member’s problems and needs: clinical, psycho-social, financial, environmental
• Provide services to members of varying ages, risk levels, clinical scenarios, cultures, financial means, social support, and motivation
• Engage members in a collaborative relationship, empowering them to self-manage their physical, psycho-social, and environmental health to improve and maintain lifelong well being
• Prepare a member-oriented plan of care with members, caregivers, and health care providers, integrating concepts of cultural sensitivity and privacy practices
• Participate in interdisciplinary rounds
• Ensure plans of care have individualized goals and interventions
• Communicate plan of care to Primary Care Physician
• Address gaps in care with the member and provider
• Address member's social determinants of health issues
• Link members to available resources
• Provide care management support during Transitions of Care
• Ensure member/caregiver understanding as it relates to language barriers, stress reactions, or cognitive limitations/barriers
• Train members on relevant chronic diseases, preventive care, medication management (medication reconciliation and adherence), home safety, etc.
• Provide Complex care management including but not limited to; ensuring access to care, reducing unnecessary hospitalizations, and appropriately referring to community supports
• Advocate for members by assisting them to address challenges and make informed choices regarding clinical status and treatment options
• Employ critical thinking and judgment when dealing with unplanned issues
• Maintain knowledge of Chronic Conditions and use job aids as a guidance
• Maintain accurate, comprehensive, and current clinical and non-clinical documentation in DCMS, the Care Management System
• Comply with all orientation requirements, annual and other mandatory training, organizational and departmental policies and procedures, and actively participate in the evaluation process
• Maintain professional competencies as a Care Manager
• Other duties as assigned by Manager.