Care Manager

Innova solutions

$93K — $104K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • NYS-licensed Registered Nurse; BSN required
  • 5+ years clinical RN experience; leadership and care coordination preferred
  • Computer-literate; EHR experience required
  • PRI/Screen certification within 3 months of hire
  • Bilingual Spanish and Case Management Certification (CCM) preferred

Responsibilities

  • Review UAS assessments, identify risk factors, and develop individualized care plans with PCPs
  • Coordinate medical, behavioral, and community services across the continuum of care
  • Monitor member conditions through regular outreach and intervene to prevent avoidable hospitalizations
  • Conduct utilization review and prior authorizations in collaboration with the Medical Director and UM team
  • Facilitate safe transitions of care and discharge planning
  • Document all care coordination activities per regulatory and organizational standards
  • Participate in interdisciplinary meetings and quality improvement initiatives

Benefits

  • Medical & pharmacy coverage
  • Dental/vision insurance
  • 401(k)
  • Health savings account (HSA) and Flexible spending account (FSA)
  • Life Insurance
  • Pet Insurance
  • Short term and Long term Disability
  • Accident & Critical illness coverage
  • Employee Assistance Program (EAP)
Full Job Description
A client of Innova Solutions is immediately hiring for a Care Manager - ED

Position type: Full-time, Contract
Duration: 3+ Months
Location: New York, NY 10004

As an Care Manager - ED you will:
Coordinate and manage the care of MLTC/MAP members through assessment, care planning, utilization review, and discharge coordination to ensure quality, cost-effective outcomes.
Key Responsibilities:
  • Review UAS assessments, identify risk factors, and develop individualized care plans with PCPs.
  • Coordinate medical, behavioral, and community services across the continuum of care.
  • Monitor member conditions through regular outreach and intervene to prevent avoidable hospitalizations.
  • Conduct utilization review and prior authorizations in collaboration with the Medical Director and UM team.
  • Facilitate safe transitions of care and discharge planning.
  • Document all care coordination activities per regulatory and organizational standards.
  • Participate in interdisciplinary meetings and quality improvement initiatives.
  • Support grievances, complaints, and quality review processes.
  • Participate in the department's on-call rotation.

Preferred Skills & Qualifications:
  • NYS-licensed Registered Nurse; BSN required
  • 5+ years clinical RN experience; leadership and care coordination preferred.
  • Computer-literate; EHR experience required.
  • PRI/Screen certification within 3 months of hire.
  • Bilingual Spanish and Case Management Certification (CCM) preferred.

Qualified candidates should APPLY NOW for immediate consideration!
This position is only open to applicants who can be engaged on a W-2 basis.
Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.
Thank you!

Jyoti Tiwari

[email protected]

PAY RANGE AND BENEFITS:
Pay Range*: $45 - $50 per hour
*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

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