Care Manager - LTSS (RN)
Fairview Hospital / Cleveland Clinic · New York, NY · 3 wk ago
On-siteHealthcareFull-time
About the role
We are seeking a Registered Nurse (RN) to provide support in care management and coordination of long-term services and supports (LTSS).
Responsibilities
- Conducting comprehensive member assessments
- Developing and implementing personalized care plans in collaboration with members and healthcare professionals
- Monitoring plan effectiveness
- Facilitating waiver enrollment processes
- Assessing medical necessity
- Ensuring appropriate service authorization
- Promoting service integration
- Evaluating benefits
- Leading interdisciplinary team meetings
- Assisting members in overcoming medical, psycho/social, and financial barriers
- Handling complex cases
- Medication reconciliation
- Providing peer consultation
- Flexibility to travel locally
Qualifications
- At least 2 years of healthcare experience, with a minimum of 1 year in care management or managed care
- Experience working with individuals with disabilities, chronic conditions, or substance use disorders
- Active, unrestricted RN license (mandatory)
Skills
- Strong communication
- Problem‑solving
- Time management
- Community resource knowledge
- Proficiency in Microsoft Office
Preferred Qualifications
- CCM certification
- Experience with LTSS populations
- Prior managed care experience
- Experience working with substance use disorder populations