Job Description
Job Title: RN Care Manager -EDJob Location: New York, NY 10004Job 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
Numbers & Facts
| Location | New York, NY |
| Salary | $65–$68 Per Hour |
Skills
Certified Case Manager (CCM)unmatched
Clinical Medicineunmatched
Computer Skillsunmatched
Discharge Plansunmatched
Health Planunmatched
Identify Issuesunmatched
Leadershipunmatched
Maintain Complianceunmatched
Multilingualunmatched
Nursingunmatched
On Callunmatched
Patient Care Denialsunmatched
Quality Managementunmatched
Registered Nurse (RN)unmatched
Regulatory Complianceunmatched
Regulatory Requirementsunmatched
Risk Analysisunmatched
Spanish Languageunmatched
Time Managementunmatched
Utilization Managementunmatched
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