Case Manager

Overview

• Provide telephonic and in-home assessments of members' medical, psychosocial, physical, and spiritual needs.
• Develop, implement, and monitor person-centered service plans ensuring continuity of care across healthcare settings.
• Collaborate with interdisciplinary care teams, PCPs, members, and specialists to meet healthcare goals.
• Educate members on disease processes, preventative health, and quality of life interventions.
• Adhere to CMS/DOH guidelines and utilize benefit structures and community resources effectively.
• Complete initial and scheduled telephonic assessments and revise service plans accordingly.
• Respond to changes in members' conditions by updating service plans and coordinating with care teams.
• Participate in interdisciplinary care team meetings to discuss member conditions and care strategies.

Key Responsibilities & Duties

• Conduct telephonic and in-home assessments to evaluate members' needs and conditions.
• Develop and implement person-centered service plans based on assessment findings.
• Monitor and revise service plans to address changes in members' health and living conditions.
• Collaborate with interdisciplinary teams to ensure comprehensive care delivery.
• Utilize Medicare and Medicaid regulations to optimize member benefits and care.
• Educate members on health maintenance and disease prevention strategies.
• Participate in case discussions during interdisciplinary team meetings.
• Adhere to organizational policies and procedures while ensuring compliance with healthcare regulations.

Job Requirements

• Graduate of an accredited nursing program; Bachelor’s degree (BSN) preferred.
• Current RN New York State license required; CCM certification preferred.
• Minimum three to five years of nursing experience in long-term care, managed care, or geriatrics.
• Experience in interdisciplinary service delivery environments is highly desirable.
• Proficiency in Medicare and Medicaid regulations and benefit structures.
• Strong communication skills, including bilingual proficiency in Mandarin/Cantonese preferred.
• Ability to work remotely following hybrid training in Manhattan.
• Commitment to providing high-quality, person-centered care to diverse populations.