MUST PERMANENTLY RESIDE IN NEW YORK - Please do not apply if you do not have a permanent residence in New York state and able to attend in person training in BAYSIDE QUEENS.

Bilingual English AND Russian or Chinese/Mandarin speaking ONLY

Position Title: Care Manager RN

Location: New York (Remote) (Must permanently reside in New York State)

Position Type: Full-Time

Reports To: Care Management Supervisor

KEY DETAILS: Virtual Orientation starts 11/17 for 2.5 weeks.

***Must be able to attend IN PERSON training for 10 days in Bayside Queens after orientation**

Position Summary: The Care Manager is responsible for coordinating and managing care services for members of a Managed Long-Term Care Service. This role involves working closely with patients, families, and healthcare providers to ensure that members receive comprehensive, individualized care that meets their long-term care needs. The Care Manager will use a holistic approach to assess, plan, implement, and evaluate care services, ensuring compliance with health plan policies and regulatory requirements.

Key Responsibilities:

• Conduct comprehensive assessments of members’ health, functional, and psychosocial needs to develop individualized care plans.

• Review and evaluate NY UAS information for members in the MLTC line of business.

• Coordinates and manages care services across multiple providers and settings, including home care, community resources, and healthcare facilities.

• Facilitate communication between members, families, and healthcare providers to ensure continuity of care and address any issues or barriers.

• Assesses and monitors the condition of the members via monthly calls.

• Identify clinical issues that require immediate attention to reduce the risk of unnecessary hospitalizations.

• Develop, implement, and regularly review care plans in collaboration with members, families, and multidisciplinary teams.

• Monitor and evaluate the effectiveness of care plans, adjusting as needed to meet changing member needs and goals.

• Timely and thorough documentation in the health record.

• Participates in weekly Interdisciplinary Care Team Meetings.

• Provide guidance and support to members and families on navigating the healthcare system and accessing appropriate services. Participates in family conferences, as needed. • Ensure care management activities comply with health plan policies, state and federal regulations, and accreditation standards.

• In collaboration with the Transition of Care Team, facilitates the discharge plan from the hospital or other alternate settings.

• Coordinates services in collaboration with the utilization management department

. • Track and report on care outcomes, quality metrics, and member satisfaction to identify areas for improvement and implement best practices.

• Conduct audits and reviews of care plans and services to ensure quality and compliance. • Identify and utilize community resources and services to support members' needs and enhance their quality of life.

• Advocate for members to access necessary services and benefits, including long term care services, medical equipment, and support services. • Manage and monitor care budgets and expenditures to ensure cost-effective use of resources.

• Provide education and support to members and families on disease management, care options, and self-care strategies.

• Offer training and guidance to other care team members on best practices in care management and coordination.

Qualifications:

• Education: Bachelor’s degree in nursing, master’s degree or advanced certification preferred.

• Bilingual preferred (ENGLISH and SPANISH) or English and Mandarin/Cantonese

• Licensure/Certification: Active & in good standing NYS RN license

• Experience: Minimum of 2 years of experience in case management, care coordination, or a related field, preferably in a managed care or long-term care setting, a plus

• Strong knowledge of long-term care services, healthcare systems, and regulatory requirements is a plus

• Excellent interpersonal, communication, and problem-solving skills.

• Proficiency in care management software, electronic health records (EHR), and other relevant technologies.

• Ability to work independently and as part of a multidisciplinary team. Work Location: • Remote Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.

• Must be able to carry, lift, push or pull at least 20lbs

Job Type: Full-time

Benefits:

• Health insurance

Application Question(s):

• Do you have an active RN license in New York?
• What language do you speak other than English?
• Do you have recent Care Manager experience?

Work Location: Remote