TravelNurseSource is working with Cynet Health to find a qualified ER/Trauma RN in New York City, New York, 10004!
Job Title: Care Manager
Profession: Care Management
Specialty: Managed Long Term Care
Duration: 8 months
Shift: 5x7
Hours per Shift: 7
Experience: Minimum of five years of clinical experience as a Registered Nurse
License: RN Licensed as a Registered Nurse in the State of New York required
Certifications: Baccalaureate degree required, PRI and Screen certification within three months of employment required
Must-Have: Bilingual (Spanish speaking), experience with care coordination, and hospital experience
Description:
The Care Manager develops, facilitates, monitors, and communicates a care plan in partnership with the member, their family or significant other, primary caregiver, and various providers.
Using assessments and interviews conducted by the Assessment Nurse, the Care Manager identifies the risk factors, strengths, challenges, and service needs of the member as they strive to keep them safe and well in their community setting.
Review and evaluate the assessment information for members.
Develop a working relationship with the primary care provider to discuss the care of the member.
Review assessment findings with the primary care provider to identify any concerns not identified by the clinical team.
Identify risk factors and assign the risk category to the member.
As part of the Care Management team, develop a formal care plan for all services needed for the member, including the member's disaster plan.
Monitor the condition of all members at least monthly, typically by telephone but face-to-face when necessary.
Identify clinical issues requiring immediate assessment and/or treatment to reduce the risk of unnecessary hospitalizations, emergency department visits, or nursing home admissions.
Identify opportunities to improve the quality of care by ensuring members receive needed preventative and chronic disease care.
Prior approve requests for additional services based on assessments and using evidence-based standards.
Assist members with coordinating services within and outside networks as appropriate.
Provide care coordination through the continuum of care.
Optimize both the quality of care and quality of life for members.
Coordinate with Utilization Management on concurrent and retrospective reviews.
Follow up with assigned nurses for clinical updates to the care plan.
Document coordination notes and routine contacts with members within two business days according to the level of risk assigned to them.
Participate in team care planning meetings.
Handle complaints that can be resolved in one day.
Assist customer service and the Utilization Management department by providing records and materials needed for grievances.
Speak to members who are delinquent in their spend-down payments.
Cooperate with all departments.
Identify members appropriate for specialty programs.
Perform all management activities in compliance with all regulatory agency requirements.
Provide information for Quality Management Department reviews by various committees.
Complete all other tasks assigned by department leadership.
Participate in the on-call schedule, which is rotated amongst the care team.