Case Manager

Overview

• Provide comprehensive case management services to ensure members' medical, psychosocial, and spiritual needs are effectively addressed.
• Develop personalized care plans to promote continuity and quality of care across healthcare settings.
• Collaborate with interdisciplinary teams, primary care providers, and specialists to optimize health outcomes.
• Educate members on disease prevention, health maintenance, and lifestyle improvement strategies.
• Ensure compliance with healthcare regulations and effectively utilize community resources to support members.
• Conduct initial and periodic assessments to revise care plans based on evolving member needs.
• Respond to changes in members' conditions, coordinating timely care adjustments as needed.
• Participate in interdisciplinary meetings to strategize and enhance member care plans.

Key Responsibilities & Duties

• Conduct thorough telephonic and in-home assessments to evaluate members' healthcare needs and goals.
• Develop and implement tailored service plans based on assessment findings and member preferences.
• Monitor and adjust service plans to address changes in members' health and living conditions effectively.
• Collaborate with interdisciplinary teams to ensure comprehensive and coordinated care delivery.
• Educate members on disease processes, preventative health measures, and lifestyle improvements.
• Utilize Medicare and Medicaid regulations to optimize member benefits and care strategies.
• Participate in case discussions during interdisciplinary team meetings to enhance care outcomes.
• Adhere to organizational policies and ensure compliance with healthcare regulations and standards.

Job Requirements

• Graduate of an accredited nursing program; Bachelor’s degree (BSN) preferred.
• Current RN license in New York State; CCM certification is 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, with bilingual proficiency in Mandarin/Cantonese preferred.
• Ability to work remotely following hybrid training in Manhattan.
• Commitment to delivering high-quality, person-centered care to diverse populations.