Transitions of Care Manager RN
2 weeks ago
Transitions of Care Manager RN
Job Ref: 106166
Category: Utilization Review and Case Management
Department: CASE MANAGEMENT PROGRAM
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Salary Range: $96,682.00 - $96,682.00
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth's provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
The primary goal of the Transitions of Care (TOC) Care Manager is to provide care coordination services as members move from one setting to another. Examples of these settings include inpatient facilities, emergency department, rehabilitation facilities, long-term care facilities, and certified home health agencies. The goal is to prevent re-admissions and reduce avoidable admissions. This is accomplished through engagement and understanding of members' need, environment, providers, support system and optimization of services available to them. In addition, ensuring follow up appointments are scheduled, conducting medication reconciliation, and providing education related to members condition and necessary steps to remain safely in the community. The TOC Care Manager is expected to assess and evaluate member needs, be a creative, efficient and resourceful problem solver. In collaboration with the members' care team, a plan of care with individualized goals and interventions is updated, implemented and evaluated.
Job Description
* Provide care management support during transitions of care.
* Complete transitions of care assessment to identify member needs.
* Complete medication reconciliation.
* Address member's problems and needs: clinical, psychosocial, financial,environmental.
* Engage members in a collaborative relationship, empowering them to self-manage their physical, psychosocial and environmental needs.
* Prepare member-oriented plan of care with member, caregiver, and members of their care team, integrating concepts of cultural sensitivity and privacypractices.
* Ensure plans of care have individualized goals and interventions.
* Communicate plan of care with primary care physician.
* Address gaps in care with the member and provider.
* Address members social determinants of health issues.
* Link members to available resources.
* Educate member and/or caregiver on relevant chronic diseases, preventive care, medication management (medication reconciliation and adherence), home safety, etc.
* Ensure access to care, reducing unnecessary hospitalizations, and appropriately referring to community supports.
* Advocate for members by assisting them to address challenges and make informed choices regarding clinical status and treatment options.
* Conduct follow up calls as per transition of care protocols.
* Employ critical thinking and judgment when dealing with unplanned issues
* Maintain knowledge of chronic conditions and use job aids as a guidance.
* Ability to use data as a tool in tracking and trending outcomes and clinical information.
* Maintain accurate, comprehensive and current clinical and non-clinical documentation in the care management system.
* Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies and procedures, and actively participate in evaluation process.
* Maintain professional competencies as a care manager.
* Other duties as assigned by Leadership.
Minimum Qualifications
* Bachelor's Degree required.
* Minimum 2 years of care management experience in a healthcare setting or in a managed care organization.
* Ability to proficiently read and interpret medical records, claims data, pharmacy, lab reports and prescriptions required.
* Ability to work closely with member and caregiver.
* Ability to work collaboratively with various team members, interdepartmentally, and leadership
* Registered Nurse with current NYS license
Professional Competencies
* Integrity and Trust
* Customer Focus
* Functional/Technical skills
* Written/Oral Communication
*
#LI-Hybrid
-
Transitions of Care Manager RN
2 hours ago
New York, NY, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth's provides the highest...
-
Transitions of Care Manager RN
1 week ago
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
Transitions of Care Manager RN
2 weeks ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth's provides the highest...
-
Transitions of Care Manager RN
4 hours ago
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth's provides the highest...
-
Transitions of Care RN
3 days ago
Miami, FL, United States CareBridge Full timeTransitions of Care RNTransitions of Care RN * Evenings and weekends are required* * Must have a Compact RN License* The Transitions of Care Registered Nurse for CareBridge is a key member of the clinical team and is responsible for providing patient outreach, triage and disease education through telehealth modalities to patients who receive Home and...
-
Transitions of Care Manager RN
2 weeks ago
New York City, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth's provides the...
-
Care Transitions RN
1 month ago
Tampa, FL, United States Tampa General Hospital Full timeCare Transitions RNUnder general supervision, provides patient education, support, and interventions to optimize care transitions. Assists in Plan of Care compliance. Includes coordination of Home Health, Remote Patient Monitoring (RPM), Durable Medical Equipment, Pharmacy as needed and communication with physicians. Uses a process of nursing intake,...
-
RN- Care Manager
5 days ago
New York, United States Village Care Full timeJob DescriptionJob DescriptionRN - Care ManagerMLTC/MAP/DSNP*Fully Remote*Join our team at Village Care as a Full Time RN- Care Manager! This exciting position offers the opportunity to work remotely, providing care and support to our members in the greater NYC area. As an integral part of our team, you will have the chance to showcase your nursing expertise...
-
Care Management Supervisor
1 week ago
New York, United States Village Care Full timeJob DescriptionJob DescriptionCare Management Supervisor - RNVillageCareMAX 112 Charles Street, New York, NY 10014VillageCare is looking for a self-motivated and passionate RN with previous Care Management experience for our Care Management Supervisor position. This role is responsible for oversight of staff, productivity, the care transition program, and...
-
Transitions of Care RN
3 days ago
Miami, FL, United States CareBridge Full timeTransitions of Care RN - Spanish Bi-lingualTransitions of Care RN - Spanish Bi-lingual * Evenings and weekends are required* * Must have a Compact RN License* The Transitions of Care Registered Nurse for CareBridge is a key member of the clinical team and is responsible for providing patient outreach, triage and disease education through telehealth...
-
RN Clinical Navigator
2 weeks ago
Jamestown, NY, United States Family Health Medical Services Full timeJob Title: RN Clinical Navigator - Transitional Care Location: Hybrid - remote and onsiteTravel Required: VariesPosition Type: Full-time, Non-Exempt Pay scale: $23 - $27 per hourSUMMARY:The RN Clinical Navigator - Transitional Care role will work with a patient after a hospitalization or other inpatient facility stay. This role will address the hand-off...
-
Senior Director, Care Transitions-Onsite
1 week ago
New York, United States Hospital for Special Surgery Full timeOverview How you move is why we're here. Now more than ever. Get back to what you need and love to do. The possibilities are endless... Now more than ever, our guiding principles are helping us in our search for exceptional talent - candidates who align with our unique workplace culture and who want to maximize the abundant opportunities for growth and...
-
Care Manager
2 weeks ago
Longmont, CO, United States Life Care Centers of America Full timeCare Manager (Registered Nurse/RN)$2,000 Sign on Bonus (FT)! $35-$46.08 and nurse on call rotation required. Position Summary The RN Care Manager is responsible for the coordination of the patient's care and services. Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of patients....
-
Registered Nurse- Transitions of Care
4 days ago
Miami, FL, United States CareBridge Full timeRegistered Nurse- Transitions of CareRegistered Nurse- Transitions of Care ($3,500 sign-on bonus) * Evenings and weekends are required* * Must have a Compact RN License* The Transitions of Care Registered Nurse for CareBridge is a key member of the clinical team and is responsible for providing patient outreach, triage and disease education through...
-
Care Manager
3 weeks ago
Corpus Christi, TX, United States Life Care Centers of America Full timeCare Manager (Registered Nurse/RN)Position Summary The RN Care Manager is responsible for the coordination of the patient's care and services. Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of patients. Works together with the patient and family, care team, payers, and external...
-
Case Manager
4 weeks ago
New York, United States Women In Need, Inc. Full timeJob DescriptionJob DescriptionTitle of Position: Case Manager Department: Transitional HousingReports to: Social Service Supervisor FLSA Status: Non-Exempt Salary: $24.49 Positions reporting to this position: None Purpose of the Position The Case Manager is responsible for case management services for clients in transitional housing. The Case Manager will...
-
Case Manager
6 days ago
New York, United States Women In Need, Inc. Full timeJob DescriptionJob DescriptionTitle of Position: Case Manager Department: Transitional HousingReports to: Social Service Supervisor FLSA Status: Non-Exempt Salary: $24.49 Positions reporting to this position: None Purpose of the Position The Case Manager is responsible for case management services for clients in transitional housing. The Case Manager will...
-
Case Manager
3 weeks ago
New York, United States Women In Need, Inc. Full timeJob DescriptionJob DescriptionTitle of Position: Case Manager Department: Transitional HousingReports to: Social Service Supervisor FLSA Status: Non-Exempt Salary: $24.49 Positions reporting to this position: None Purpose of the Position The Case Manager is responsible for case management services for clients in transitional housing. The Case Manager will...
-
Case Manager
4 weeks ago
New York, United States Women In Need, Inc. Full timeJob DescriptionJob DescriptionTitle of Position: Case Manager Department: Transitional HousingReports to: Social Service Supervisor FLSA Status: Non-Exempt Salary: $24.49 per hour Positions reporting to this position: None Purpose of the Position The Case Manager is responsible for case management services for clients in transitional housing. The Case...
-
Transition of Care LPN
2 weeks ago
Seattle, WA, United States Sea Mar Community Health Centers Full timeSea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons without...
