About the Role
Title: Registered Nurse, Care Manager
Location: Tonawanda, NY United States
Job Description:
- THIS POSITION MAY BE ELIGIBLE FOR UP TO A $15,000 SIGN-ON BONUS (restrictions may apply) *
The Care Manager is responsible for providing care management to a group of health plan members, creating the Person-Centered Service Plan (PCSP), coordination of services, and documentation of care in accordance with health plan standards and under the guidance of the Care Management Supervisor.
Performance Responsibilities and Standards:
- Provides care management for members through an interdisciplinary approach through assessment, planning, facilitation, and advocacy for support and services to meet a member’s needs.
- Implements an appropriate, quality, and cost-effective plan of care that utilizes all resources available to meet the members needs in collaboration with the member, family, health care team, medical providers, and other community-based programs based on the UAS-NY assessment.
- Oversees caseload of managed care members.
- Performs all care management activities in compliance with all regulatory agency requirements; completes required documentation, that is clear and concise and is done in a timely manner (organizational standards). Responsible for coordination of health plan support staff, including LPN, Community Health Workers, and Care Coordination; provide guidance and education to efficiently manage patients using a team approach.
- Participate in departmental meetings and attend all scheduled staff meetings and training as applicable and required.
- Adhere to all state and federal privacy regulations, including HIPAA and Nascentia Health Options policies and agreements regarding confidentiality, privacy, and security.
- Communicate and collaborate effectively with potential members, their families, health plan staff, and providers.
- Acts as a liaison and member advocate.
- Demonstrates cultural competence by respecting and being responsible for the member’s cultural health beliefs, language needs, and support system.
- Other duties as assigned.
Requirements:
- Nursing: License and current registration as a Registered Professional Nurse in New York State. Education: BSN preferred; associate degree required. Minimum of one year of Nursing Experience is required.
- Long-term care and/or managed care experience a plus
- Knowledge of homecare, Medicare, and Medicaid is a plus.
- Care Management Certification is a plus.
- Bilingual skills a plus
- Ability to work independently and prioritize workload.
- Computer literate and working knowledge of basic computer skills and Microsoft Office programs.
- Strong communication skills, both person-to-person, virtually, and by phone.
- Valid NYS drivers license and ability to drive in all types of weather.
- Ability to learn and routinely utilize the organizations software systems to perform required job duties.
Physical Requirements:
- The role is to work from home with the requirement to visit health plan members in their homes. Attendance of in-office work and meetings may be required.
- Standard postures include Standing, sitting, bending, walking, and driving (frequently entering and exiting vehicles throughout the day).
- Frequently uses a laptop computer to enter orders and obtain product information.
- Sensory requirements include speech, vision, smell, and hearing.
- Lifting requirements of up to 20 pounds frequently and up to 50 pounds occasionally
- Bloodborne Pathogens Exposure Category I – Employee has tasks that routinely involve exposure or potential exposure to blood, body fluids, or tissues.
Compensation & Benefits:
Competitive Salary [This is an S03 exempt position with a min-max rate of: $72,415.71- $83,922.76 /annually]with:
- $15,000 sign-on bonus (restrictions may apply)
- Retention bonuses
- 401k with generous Employer match
- Medical, Dental, Vision plans
- Tuition Reimbursement for BSN after 6 months of employment
- Exceptional work/life balance – no rotating shifts, holidays or weekends
- Partially funded HSA
- Employee Recognition Platform
- Paid Time Off, Holidays, and Extended Sick Leave
- Short/Long term Disability
- Employee Assistance Program (EAP)
- Much More!