Bilingual Community Care Manager (RN)

The Execu|Search Group
Aug 13, 2017
Aug 14, 2017
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

About the Opportunity A premier health service provider in New York City is actively seeking a Spanish-speaking, licensed Registered Nurse (RN) for a promising opportunity on their staff as a Community Care Manager (RN). In this role, the Bilingual Community Care Manager (RN) works in collaboration with the member's Primary Care Provider (PCP) and an interdisciplinary team to proactively manage members with complex medical, behavioral and psychosocial needs. Apply today! Company Description Health Service Provider Job Description The Bilingual Community Care Manager (RN) will: * Conduct face-to-face and telephonic assessments of members' functional status, medical, behavioral, psychosocial and community resource needs * Organize Interdisciplinary Care Team (ICT) meetings and act as facilitator to ensure that members' needs are met * Develop an ICP based on members' clinical, behavioral and social needs that incorporates barriers to care * Coordinate and arrange for all services required by a member in accordance with the ICP * Monitor members' health status and ensure that member is receiving all necessary medical and supportive services * Modify ICP as appropriate to member's needs and progress * Monitor/manage service utilization to optimize benefits to support access to services that improve health care outcomes * Provide utilization management and issuance of appropriate authorizations for covered services * Manage care transitions through effective and timely communication necessary for member care and discharge planning * Clarify plan medical benefits, policies and procedures for members, providers and community based agencies * Prepare for and participate in clinical case reviews to share best practices * Adhere to documentation policies and procedures including documentation of Care Management activities and their effectiveness Required Skills * Active New York State Registered Nurse license * Bilingual (English and Spanish) * Strong medical skills and knowledge * Knowledge of chronic disease management * Strong professional level of knowledge and comprehensive clinical assessment skills in the adult population and chronic disease management * Outstanding communication skills * Patient-oriented * Competent in Microsoft Office Products (Outlook, Word, and Excel) * Ability to work independently and maintain flexibly in a fast-paced start-up environment * Ability to analyze data and use it to improve care delivery Desired Skills * Knowledge of Medicare and Medicaid programs * 2+ years of current clinical nursing experience with home care, case management, recent acute care experience, or physician office experience * Medicare/Medicaid managed care experience * Experience working with a geriatric population or equivalent experience