RN Care Manager Job at RCM Health Care Services
RN Care Manager, MLTC
Remote job after new hire completes 4 – 6 months hybrid training: 2 days in office / 3 days remote
Salary range: $85,000 – $105,000 based on education and experience
$15,000 Sign-on Bonus
Position Overview:
An employee in this role provides telephonic assessments of members’ medical, psychosocial, physical and spiritual needs. He/She develops, implements, and monitors person centered service plan, and ensures continuity of care across all healthcare settings by collaborating with the interdisciplinary care team, PCP,
member/member’s representatives, and specialists. Utilizes benefit structure and community-based resources to meet member’s needs. Educates members on disease processes, preventative health, and quality of life interventions. RN Care
Manager will be knowledgeable in and adhere to CMS/DOH regulations and policies.
develop a Person Centered Service Plan (PCSP)
Qualifications:
NY State RN license, BSN preferred
Minimum three to five years nursing experience in long term care, managed care,
home care, geriatrics or hospice
Prior experience in an interdisciplinary service delivery environment preferred.
Working knowledge of Medicare and Medicaid regulations
Prior experience in an interdisciplinary service delivery environment preferred.
INDP
Remote job after new hire completes 4 – 6 months hybrid training: 2 days in office / 3 days remote
Salary range: $85,000 – $105,000 based on education and experience
$15,000 Sign-on Bonus
Position Overview:
An employee in this role provides telephonic assessments of members’ medical, psychosocial, physical and spiritual needs. He/She develops, implements, and monitors person centered service plan, and ensures continuity of care across all healthcare settings by collaborating with the interdisciplinary care team, PCP,
member/member’s representatives, and specialists. Utilizes benefit structure and community-based resources to meet member’s needs. Educates members on disease processes, preventative health, and quality of life interventions. RN Care
Manager will be knowledgeable in and adhere to CMS/DOH regulations and policies.
- Completes initial telephonic assessments and reviews UAS -NY visit data as assigned by the Supervisor of Coordinated Care in accordance with departmental workflow. Utilizes completed assessments to develop a Person Centered Service Plan (PCSP)
- Completes all telephonic Care Plan assessments assigned within a given month for members
- For members enrolled into MAP or HF, RN Care Manager will review the initial packet within 7 business
within 30 days of enrollment, but no later than 90 days
- Generate a comprehensive PCSP that addresses all aspects of member’s needs including medical, social,
- Assist the member to access all necessary covered services as identified in the Person Centered Service
support of the PCSP, irrespective of whether the needed services are included in the Benefit Package
- Identify opportunities to educate on care gaps (i.e. missing preventative health recommended
coordinate care
- Comprehensive Care Plan is completed and documented in the care management database with an error
- Make reasonable efforts to effectively communicate with providers and members during the PCSP
develop a Person Centered Service Plan (PCSP)
Qualifications:
NY State RN license, BSN preferred
Minimum three to five years nursing experience in long term care, managed care,
home care, geriatrics or hospice
Prior experience in an interdisciplinary service delivery environment preferred.
Working knowledge of Medicare and Medicaid regulations
Prior experience in an interdisciplinary service delivery environment preferred.
INDP
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