Nurse - Care Manager

Overview

This RN is responsible for providing care management for a group of members through a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet a member's health needs through communication and available resources. Develops comprehensive care plan for identified needs. Coordinates all of these services to ensure effective organization of long-term care and health-related services across the spectrum of community-, home-, and facility-based settings. Required Skills & Experience - RN License in New York State. - BSN preferred, Associates Degree required. - 1 year of long term care or managed care nursing experience required. - Knowledge of homecare, Medicare and Medicaid preferred - Case Management Certification Preferred - Bilingual skills preferred - Valid NYS drivers license and ability to drive in all types of weather What you need to know: - Conducts home/ facility visits for comprehensive health assessments and reassessments to identify health and environmental needs. - Revises and amends care plan as needed based on changes to the members physical, mental, or social wellbeing (this is done at least every 6 months or whenever a change occurs). - In collaboration with members, develops their individualized short and long term goals - Utilizes care standards and strategies to develop comprehensive individualized care plan for identified needs. - Home visit to member minimally at least every six months. - Performs at minimally a monthly phone call to member to review care plan services and any health change status. - Document all member activity in the Medical record on a timely basis. - Closely communicates and collaborates with member, their Primary Care Provider, interdisciplinary team, caregivers and family. - Participates in care conferences with Medical Director on an as needed basis.

Benefits

Company

As a healthcare system without walls, this health system will take a holistic approach to patient care, addressing immediate needs, supporting positive long-term medical and lifestyle choices, and leveraging leading-edge in-home care approaches and technologies to improve outcomes and quality of life. Specialties will include: in-home nursing and medical services; home health aides and elder care; complete cross-continuum care management; community health and wellness programs; transportation, equipment and innovative care technologies; chronic disease management; and managed long-term care. With the right approach, the right team, and the right resources and technologies, our health system delivers tomorrow’s healthcare today, promising more effective care and a healthier community.