Registered Nurse (RN) Care Manager – MLTC

Role Overview

• The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services
• Ensures consistent care along the entire health care continuum by assessing and closely monitoring members’ needs and status
• Authorizes covered services and coordinates care regardless of payer
• Collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team
• Works with member/family to maintain the most independent living situation possible
• Performs home visits as required to assess members’ living situation
• Collaborates with the primary care physician and Inter-Disciplinary Team to develop the Patient Centered Service Plan for the member
• Identifies same day grievances, investigates and documents accordingly

Requirements

• Associates degree in Nursing from an accredited nursing program required
• Bachelor's degree in Nursing preferred
• Three (3) years of experience as a registered nurse required
• Clinical experience in geriatrics and/or managed long-term care experience preferred
• Experience using multiple languages may be required based on operational needs

Benefits

• substantial and comprehensive total rewards package
• bonus tied to company and individual performance