Job Title: RN Care Manager -ED
Job Location: New York, NY 10004
Job Duration: 3 Month (Possibility of extension)
Shift time: 9AM to 5PM , Hybrid
Pay – $65/hr. – $68/hr. on w2
Note: We have openings for Manhattan/ Brooklyn/ Bronx/ Queens (choose any location, shift, department as per experience)
Position Overview:
Role & Responsibilities:
- Ensure compliance with regulatory requirements and participate in the rotating on-call schedule.
- Document member contacts and care coordination activities within two business days.
- Coordinate with Utilization Management and Quality Management teams.
- Review additional service authorization requests and refer denials or reductions to the Medical Director when needed.
- Coordinate care transitions, discharge planning, and services across in-network and out-of-network providers.
- Assess member risks and identify clinical issues requiring timely intervention.
- Develop and monitor individualized care plans in coordination with members, physicians, nurses, and other providers.
- Review member assessments and UAS information for MLTC and MAP programs.
Skills:
- Minimum of five (5) years of clinical experience as a Registered Nurse
- Leadership experience preferred
- Experience in: Care Coordination, Utilization Review, Discharge Planning
- Computer literacy required
- Bilingual Spanish Certification in Case Management
Education & Licensure:
- Licensed Registered Nurse (RN) in the State of New York (required)
- Baccalaureate degree (required)
- PRI and Screen certification required within three (3) months of employment
- Preferred Qualifications: Master’s Degree