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Registered Nurse Care Coordinator

2 months ago

New York, New York, United States Belong Health Full time

Welcome to Belong Health.

At Belong, we collaborate with regional payers to provide Medicare Advantage and Special Needs Plan offerings. Our mission is to transform health insurance for seniors and other Medicare-eligible individuals through a combination of data-driven clinical interventions and compassionate patient care.

We believe that recognizing individuals strengthens communities.

POSITION OVERVIEW

The Registered Nurse (RN) Care Manager plays a pivotal role in Belong Health's Dual Special Needs Plan (DSNP) program. This position involves utilizing care management strategies to engage members effectively and coordinate their healthcare services. The RN Care Manager will foster collaborative relationships with healthcare providers, community resources, and the Belong Health team.

KEY RESPONSIBILITIES

  • Provide clinical oversight for Medicare beneficiaries with complex medical needs.
  • Guide new members through the Belong Health DSNP program and educate them and their caregivers about available care management services.
  • Empower beneficiaries by informing and educating them on self-management techniques.
  • Conduct thorough assessments to identify barriers and opportunities for intervention.
  • Develop and execute the Individual Care Plan (ICP).
  • Facilitate interdisciplinary care team meetings.
  • Collaborate with healthcare providers, social workers, discharge planners, and community service organizations to ensure coordinated care and achievement of care plan objectives.
  • Document all care management activities accurately in accordance with established procedures.
  • Engage continuously with members, their families, advocates, providers, and community organizations to coordinate care and eliminate barriers.
  • Promote a culture of accountability and performance, ensuring timely resolution of complex customer issues.
SUPERVISORY ROLE

This position does not entail supervisory responsibilities.

QUALIFICATIONS AND EXPERIENCE
  • Active, unrestricted nursing license in New York (RN) required.
  • Knowledge of Medicare and Medicaid programs, along with experience in regulatory compliance.
  • Proficient in navigating various healthcare systems.
  • Minimum of two years' experience in a health plan, healthcare organization, community-based organization, or social services environment.
  • Prior experience in care management is essential.
  • Understanding of elder care services and the dynamics affecting disadvantaged populations.
  • Experience in cross-departmental projects and policy changes.
  • Strong customer service, problem-solving, and analytical skills.
  • Commitment to ethical standards and confidentiality of member information.
  • Excellent communication skills, both oral and written.
  • Proficient in Microsoft applications.
  • Strong organizational skills and attention to detail.
PREFERRED QUALIFICATIONS
  • Familiarity with community services and resources for elders and disabled individuals.
  • Experience in a managed care or HMO setting is preferred.
  • Bi-lingual Spanish speaking is a plus.
EDUCATION
  • A degree in Nursing is mandatory.
CERTIFICATION
  • An active, unrestricted nursing license in New York is required.
  • Care Management Certification is preferred.
HEALTH AND SAFETY POLICY

Belong Health and its partners require full vaccination for associates and select contractors conducting work on behalf of Belong Health. This applies to those who interact directly with members and patients or represent Belong Health at events. Exemptions for medical and religious reasons will be considered in accordance with state and local laws.

SALARY RANGE
  • $80,000-$95,000
Belong Health is an equal opportunity employer and encourages applicants from diverse backgrounds to apply.

Our organization participates in E-Verify to confirm employee eligibility to work in the United States.