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Clinical Care Management Nurse
2 months ago
Join our team and make a significant impact on the lives of our 28 million members as a vital clinical professional within our Medical Management/Health Services division.
As a key member of our organization, you will:
- Conduct thorough assessments with members, caregivers, or providers to gather essential information regarding client status, support systems, and service needs for effective care plan formulation.
- Oversee the delivery of services and maintain follow-up with members, caregivers, or providers through both in-person visits and telephonic communication.
- Authorize and coordinate referrals for necessary services.
- Ensure that provider services are executed seamlessly and identify any functional gaps in care plans.
- Assist in the coordination of informal or voluntary services to enhance the member care plan.
- Collaborate with discharge planners, physicians, and other stakeholders to ensure the development of appropriate discharge and care plans, as well as coordination of acute and long-term care services.
- Support members in filing and resolving complaints and appeals.
- Direct care to participating network providers.
- Engage in care management committees and contribute to special projects related to care management as required.
Qualifications:
To be successful in this role, you should possess:
- A minimum of 3 years of experience in care management, with a preference for backgrounds in home health, discharge planning, or long-term care.
- A valid driver's license.
- A New York State RN license.
Compensation:
Compensation for this position ranges from $25.97 to $46.68 per hour, depending on individual skills, experience, education, and other job-related factors.
We offer a comprehensive benefits package that includes competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements including remote, hybrid, field, or office schedules.
We are proud to be an equal opportunity employer committed to diversity and inclusion, valuing the unique perspectives that each individual brings to our organization.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.
