Nurse Care Manager
5 days ago
VNS Health is seeking a skilled Nurse Care Manager to join our team. As a key member of our care management team, you will play a critical role in ensuring our members receive high-quality, cost-effective healthcare services.
Key Responsibilities- Assess and Coordinate Care
- Conduct comprehensive reviews of member needs and identify solutions that promote high-quality and cost-effective healthcare services.
- Manage providers, members, team, or care manager-generated requests for medical services and render clinical determinations in accordance with healthcare policies and applicable state and federal regulations.
- Coordinate Care Management
- Deliver timely notification detailing clinical decisions.
- Coordinate with management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely, and cost-effective.
- Provide Clinical Support
- Participate in case conferences with management.
- Identify opportunities for alternative care options and contribute to the development of patient-focused plans of care to facilitate safe discharges and transitions back into the community after hospitalization.
- Ensure Compliance and Quality
- Ensure compliance with state and federal regulatory standards and VNS Health policies and procedures.
- Improve clinical and cost-effective outcomes, such as reduction of hospital admissions and emergency department visits, through ongoing member education, care management, and collaboration with interdisciplinary team members.
- Licenses and Certifications
- Current license to practice as a Registered Professional Nurse in New York State required.
- Certified Case Manager preferred.
- 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.
- Work 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.
- Must have experience and qualifications demonstrating knowledge of working with the Long-Term Services and Supports (LTSS) eligible population.
VNS Health is one of the nation's largest nonprofit home and community-based healthcare organizations. We innovate in healthcare for more than 125 years, driven by our commitment to health and well-being. We help people live, age, and heal where they feel most comfortable, in their own homes, connected to their family and community.
Benefits- Guaranteed Hours
- 401k retirement plan
- Employee assistance programs
- Dental benefits
- Vision benefits
- License and certification reimbursement
- Life insurance
- Discount program
- Holiday Pay
- Continuing Education
- Wellness and fitness programs
- Mileage reimbursement
- Medical benefits
- Benefits start day 1
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