Case Manager

Overview

• Deliver comprehensive care management services, conducting assessments to address medical, psychosocial, and spiritual needs of members.
• Develop and implement personalized service plans ensuring continuity across healthcare settings and improving member outcomes.
• Collaborate with interdisciplinary teams, primary care providers, and specialists to create effective care strategies.
• Educate members on disease management, preventive health strategies, and enhancing quality of life.
• Respond proactively to changes in member conditions, revising service plans as needed to meet evolving needs.
• Ensure compliance with healthcare regulations and organizational standards in all aspects of care management.
• Participate in interdisciplinary meetings to discuss member conditions and coordinate care strategies effectively.
• Utilize community resources and benefit structures to optimize care delivery and member satisfaction.

Key Responsibilities & Duties

• Conduct telephonic and in-home assessments to evaluate member needs comprehensively.
• Develop and update person-centered service plans based on assessment findings and member preferences.
• Collaborate with interdisciplinary teams to ensure seamless and effective care delivery.
• Educate members on health management strategies to improve outcomes and quality of life.
• Monitor member progress and adapt care plans to address changing needs and conditions.
• Ensure compliance with Medicare and Medicaid regulations in all care management practices.
• Participate actively in team meetings to discuss cases and coordinate care strategies.
• Utilize organizational workflows and guidelines to maintain high standards of service delivery.

Job Requirements

• Associate degree in nursing required; Bachelor’s degree (BSN) preferred.
• Current RN license in New York State; CCM certification highly desirable.
• Three to five years of nursing experience in long-term care, managed care, or geriatrics.
• Proficiency in conducting assessments and developing personalized service plans.
• Knowledge of Medicare and Medicaid regulations and interdisciplinary care practices.
• Strong communication and collaboration skills with interdisciplinary teams.
• Bilingual proficiency in Mandarin/Cantonese is highly desirable.
• Ability to manage care remotely while maintaining high standards of service delivery.