Qualifications

• Graduate from an accredited School of Nursing; Baccalaureate required, Master's preferred in Nursing, Social Work, or related field.
• Minimum one year of clinical experience in nursing or social work is required.
• Preferred experience in managed care, particularly in utilization or case management.
• 1 to 3 years of management experience is preferred.
• Valid NYS RN or SW License; CCM certification preferred.
• Strong clinical assessment and disease management abilities are essential.
• Excellent verbal and written communication skills are required.

Responsibilities

• Oversee daily operations of the clinical care management team to ensure effective patient care delivery.
• Ensure timely evaluation and implementation of individualized care plans for at-risk and chronically ill members.
• Impact self-management of members and improve clinical outcomes through service and intervention guidance.
• Enhance quality of life for members through effective care coordination and support.
• Mentor and support team members by providing direction and fostering a collaborative work environment.

Benefits

• Hybrid work model offering flexibility between remote and in-office work.
• Supportive environment focused on professional development and mentorship.
• Access to resources that improve team collaboration and patient care outcomes.