Registered Nurse Care Manager

21 hours ago


Costa Mesa, California, United States HealthEcareers - Client Full time
About the Role

We are seeking a highly skilled Registered Nurse Care Manager to join our team at HealthEcareers - Client. As a key member of our care management team, you will play a vital role in ensuring our members receive high-quality, cost-effective healthcare services.

Key Responsibilities
  • Assess and Coordinate Care: Conduct comprehensive reviews of member needs, identify solutions, and coordinate care with healthcare providers, members, and team members.
  • Manage Requests for Services: Review and approve requests for medical services, ensuring they meet medical necessity criteria and are conducted in the right setting.
  • Ensure Compliance: Ensure compliance with state and federal regulatory standards, as well as VNS Health policies and procedures.
  • Participate in Case Conferences: Collaborate with management and other team members to discuss member cases and develop effective care plans.
  • Identify Opportunities for Improvement: Analyze department processes and procedures to identify areas for improvement and provide recommendations for enhancement.
Requirements
  • Education: Associate's Degree in Nursing or a Master's degree in Occupational Therapy required; Bachelor's Degree or Master's degree in nursing preferred.
  • Experience: Minimum two years of experience with strong cost containment/case management background or two years acute inpatient hospital experience in chronic or complex care required.
  • Licenses and Certifications: Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York State required; Certified Case Manager preferred.
What We Offer
  • Competitive Salary: A competitive salary and benefits package, including medical, dental, and vision insurance, 401(k) retirement plan, and employee assistance programs.
  • Opportunities for Growth: Opportunities for professional growth and career advancement, including tuition reimbursement and continuing education programs.
  • Collaborative Team Environment: A collaborative team environment that values innovation, teamwork, and excellence in patient care.

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