Job Description:
• Empower members’ families to support optimal wellness while advocating for necessary medical services across the health care continuum
• Work in a telephonic managed care setting to facilitate individualized plans of care for high-risk members
• Assess members’ physical, functional, psychological, environmental, educational, and financial needs
• Complete needs assessments and develop individualized care plans
• Assign risk stratification and determine ongoing call frequency
• Monitor care plans, service provision, benefits adequacy, progress toward goals, and changes in health status
• Interface with providers to coordinate appointments, transportation, DME, and other services
• Educate members about conditions, treatment plans, benefits, services, and accessing care
• Provide community-resource referrals and facilitate access and communication among multiple services
• Participate in interdisciplinary and client rounds to identify, clarify, or prevent risk, quality, or care-plan variances
Requirements:
• Preferred EST or CST time zone
• Current, unrestricted Registered Nurse (RN) license in NY State required
• Three (3) or more years of clinical experience in a Level III or above NICU required
• CCM certification required within the timeframe specified by company policy
• Experience with data entry into a database or EHR required
• Must be computer literate
• Excellent communication skills and organizational ability required
• Must be self-motivated and willing to learn multiple tasks
• Must be well organized and able to prioritize tasks
• Must demonstrate accuracy in spelling and documentation
• Strength working independently and collaboratively within a team
• Excellent interpersonal skills and telephone etiquette
• Commitment to excellence in customer service
• College degree preferred
Benefits:
• Paid Time Off
• Paid Parental Leave
• Medical, dental, vision benefits
• 401K with company match
• Short- and Long-Term Disability
• Group Life Insurance
• Tuition reimbursement
• Professional development opportunities
• Business Casual work environment