Travel Nurse RN - Emergency Room (ER) / Trauma - $2,268 per week in New York City, NY

Job Title: Care Manager Profession: Care Manager Specialty: ED Duration: 8 months Shift: 5 days per week Hours per Shift: 7 hours Experience: Minimum of 5 years of clinical experience as a Registered Nurse. Leadership experience preferred. 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 is required. Master’s Degree and Bilingual Spanish Certification in Case Management preferred. Must-Have: Review assessments, hospital experience, bilingual (Spanish speaking), care coordination 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, primary and/or attending physicians, and various providers. Using assessments and interviews conducted by the Assessment Nurse, the Care Manager identifies risk factors, strengths, challenges, and service needs of members as they strive to keep them safe and well in their community settings. The Care Manager reviews and evaluates the assessment and UAS information for members in the MLTC and MAP lines of business. Developing a working relationship with the PCP allows the Care Manager to contact and discuss the care of the member. Assessment findings are reviewed with the PCP to identify any concerns that have not been identified by the clinical team. Risk factors are identified and risk categories are assigned to members. As part of the Care Management team, a formal care plan for all services needed for the member, including the member’s disaster plan, is developed. The Care Manager monitors the condition of all members at least monthly, typically by telephone but in person when necessary. Clinical issues that require immediate assessment and/or treatment to reduce the risk of unnecessary hospitalizations, ED visits, or nursing home admissions are identified. Opportunities to improve the quality of care are identified by ensuring members receive needed preventative and chronic disease care. Requests for additional services are approved based on assessments and using evidence-based standards. Denials, reductions, or limitations of service requests are referred to the Medical Director. The Care Manager assists members with the coordination of services within and outside networks as appropriate. This includes facilitating discharge from acute settings and alternate settings. Care Coordination is provided throughout the continuum of care. Quality of care and quality of life for members are optimized. Coordination with the Utilization Management (UM) department occurs on concurrent and retrospective reviews. The Care Manager follows up with assigned nurses for clinical updates to care plans. Documentation within two business days of coordination notes and routine contacts with members is completed according to assigned risk levels. Participation in team care planning meetings is expected. Complaints that can be resolved in one day are handled. Assistance is provided to Customer Service and the UM department by supplying records and materials needed for grievances from MLTC/MAP program members. Conversations with members who are delinquent in their spend-down payments are conducted. Collaboration with all departments is essential. Members appropriate for specialty programs are identified. All MLTC/MAP management activities are performed in compliance with regulatory agency requirements. Information on all requests from the Quality Management Department is provided to be reviewed by various Quality committees. Completion of all other tasks assigned by department leadership is required. Participation in the department on-call schedule is necessary, which is rotated amongst the care team.