*** THIS POSITION MAY BE ELIGIBLE FOR UP TO A $15,000 SIGN-ON BONUS ***The Care Manager is responsible for providing care management to a group of health plan members, creating the Person-Centered Service Plan (PCSP), coordinating services, and documenting care in accordance with health plan standards, under the guidance of the Care Management Supervisor.
This is a Remote Role | Monday Friday, 8:00 AM 4:30 PM 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 member's 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: 1. 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.
2. Long-term care and/or managed care experience a plus
3. Knowledge of homecare, Medicare, and Medicaid is a plus.
4. Care Management Certification is a plus.
5. Bilingual skills a plus
6. Ability to work independently and prioritize workload.
7. Computer literate and working knowledge of basic computer skills and Microsoft Office programs.
8. Strong communication skills, both person-to-person, virtually, and by phone.
9. Valid NYS driver's license and ability to drive in all types of weather.
10. Ability to learn and routinely utilize the organization's software systems to perform required job duties.
Physical Requirements: - This role offers the benefits of a remote-first work environment, supporting work-life balance and flexibility. Employees may occasionally attend in-person training or team events a few times per year.
- Standard postures include standing, sitting, bending, walking, and driving.
- 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: $75,250- $87,138.92 /annually] with:
- $15,000 sign-on bonus*
- 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!
