RN Care Manager - Full Time - Days

Core Job Responsibilities

• Identifies and coordinates enrollee services as provided by the plan and services that are not a benefit of the plan (Medicare Services).
• Completes comprehensive assessment using the DOH approved tool to determine eligibility of medically necessary services.
• Educates and completes with enrollee all necessary consents and documentation.
• Initiates and carries out continuous assessment of physical, emotional, social, cultural, economic, and environmental needs of the enrollee and coordinates services for needs as determined.
• Observes the enrollee for changes in condition and follows up with appropriate services or providers to attempt to prevent disease exacerbations.
• Develops, monitors and revises a Plan of Care with the enrollee or enrollee’s designee that has problem, enrollee centered goals and interventions.
• Implements orders for Durable Medical Equipment items and treatments as prescribed by the physician, submitting and maintaining appropriate medical orders and documentation.
• Completes documentation per company standards/policy utilizing an Electronic Medical Record (EMR) system.
• Participates in Marketing Activities as requested by Executive Director or Designee.
• Accepts assignments and performs duties within their nursing scope of practice, seeking and obtaining sufficient information/education necessary to function effectively in the managed long term care setting.
• Participates in departmental and organizational committees and meetings as applicable.
• Participates in the orientation of new staff, mentors peers, and promotes collaborative teamwork.
• Performs all duties and responsibilities in accordance with the Nurse Practice Act and in accordance with the basic principles of professional nursing.
• Maintains a working knowledge of, and adheres to applicable federal/state regulations including, but not limited to, patient confidentiality, release of information, and HIPAA.
• Performs related duties as assigned.
• Clarifies issues and actively addresses concerns in a timely manner.
• Ability to manage conflict, stress, and multiple simultaneous work demands in an effective, professional manner.
• Ability and willingness to self-motivate, prioritize, and be willing to change processes to improve effectiveness efficiency. Adapts to changing enrollee or organizational priorities.
• Ability to make independent decisions in accordance with established policies and procedures.

Education/Experience Requirements

• Computer literacy, including but not limited to data entry, retrieval, and report generation.
• Excellent written, verbal and listening communication skills.
• Strong organizational and time management skills.
• Ability to work with patients/families of all ages and in a variety of settings, including inpatient facility and patients’ homes presenting diverse physical conditions and social/cultural environments.
• Ability to drive to and from a variety of settings in varying weather conditions.

Licensure/Certification Requirements

• Licensed and currently registered to practice as a Registered Professional Nurse or BSN in New York State, with preferred 1-2 years in community based care or health care area that cares for the community population.
• Valid New York State driver’s license and personal vehicle.
• Current Basic Life Support (BLS) Certification.

Job Details

• Req Id 96573
• Department CARE MGMT SVCS
• Shift Days Shift Hours Worked 8.50
• FTE 1
• Work Schedule SALARIED GENERAL
• Employee Status A1 - Full-Time
• Union Non-Union
• Pay Range $66,000 - $100,000 Annually