- Provides care management for a group of members through a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet a member's health needs through communication and available resources.
- Implements appropriate quality and cost-effective plan of care the utilizes all resources available to meet members needs in collaboration with member, family, health care team, medical providers, and other community-based programs.
- Revises and amends care plan as needed based on changes to the members physical, mental, or social wellbeing and utilizes care standards and strategies to develop comprehensive individualized care plan for identified needs.
- Utilizes evidence-based health strategies to prevent hospitalization and inappropriate utilization of Emergency Room visits.
- Uses approaches and tools to engage members and their families in reaching their optimum level of wellness, self-care management and functional capabilities.
- Oversees caseload of managed care members.
- Review and evaluate the members assessment information along with clinical data and notes.
- Completes monthly phone contacts to each member per agency contact standards.
- Makes referrals to appropriate health and community-based resources in a timely manner.
- Document all member activity in the Medical record on a timely basis.
- Review and authorizes request for services according to workflow and timeframes.
- Closely communicates and collaborates with member, their Primary Care Provider, interdisciplinary team, caregivers, and family.
- Participates in care conferences with Supervisor.
- Promotes quality cost-effective outcomes.
- Maintains members in the most independent living situation possible.
- Ensures consistent care along entire health care continuum by assessing and closely monitoring members' needs and status.
- Acts as a liaison and member advocate.
- Demonstrates cultural competence by being respectful of and responsible to cultural health beliefs, language needs of member and their support system.
- Provides services and authorizes/coordinates services within a capitated managed care system.
- Accurately and completely documents communications with care providers, network providers, members, families.
- Ensures compliance with all State and Federal regulations, and requirements.
- Participates in Quality Assurance and Improvement activities.
- Other duties as assigned.
- Nursing: License and current registration as a Registered Professional Nurse in New York State
- One year of Nursing Experience preferred
- Long term care and/or managed care experience required.
- Knowledge of homecare, Medicare and Medicaid preferred
- Case Management Certification Preferred
- Bilingual skills preferred.
- Ability to work independently, multiple assignments, prioritize workload.
- Computer literate and working knowledge of basic computer skills and Microsoft Office programs.
- Strong communication skills person to person and by phone.
- Ability to learn organizations software system to perform job duties.
- Ability to sit or stand at a desk 90% of the day
- Visual/hearing ability sufficient to comprehend written or verbal communication
- Ability to express self verbally and in writing
- Ability to use telephone and communicate over the phone
- Frequently uses a laptop computer to enter orders and obtain product information
- Bloodborne Pathogens Exposure Category III - Employee who rarely has contact with blood and body fluids
- 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
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registered nurse, care manager - Latham, NY , USA, United States - Nascentia Health
Description
THIS POSITION IS ELIGIBLE FOR A $15,000 SIGN-ON BONUS
The Care Manager (Registered Nurse) coordinates medically necessary services to ensure effective organization of long-term care and health-related care across and does require travel throughout the county/region you may oversee.
Education:
BSN preferred; Associates Degree required.
Competitive Salary [This position is an S03 exempt position with a min-max rate of: $70,131-$94,274/annually] with:
* $15,000 sign-on bonus
About Nascentia Health:
Nascentia Health is leading the way in home care, post acute care and long-term community health.
A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole.
By serving people in their homes, Nascentia Health is able to provide true holistic care.We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.
Our employees are our greatest asset.They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve.
We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.
________________________________________________Nascentia Health is an Equal Opportunity Employer (EOE)
Employment is contingent upon negative results of a pre-hire drug screen
