Nurse Care Manager

5 days ago


Secaucus, New Jersey, United States VNS Health Full time
About the Role

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.
Requirements
  • 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.
About VNS Health

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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