RN Care Manager

$68,640 - $93,600/Yr

Elderwood - Buffalo, NY

Full-time - Mid Level

Remote - Buffalo, NY

Nursing and Residential Care Facilities

About the position

Elderwood IPA is seeking an RN Care Manager to join our growing team in Buffalo, NY. This full-time position offers a Monday-Friday schedule with no weekends or overnights, and remote working options. The RN Care Manager will play a critical role in assessing members' home health and care needs, coordinating necessary services, and providing referrals to ensure comprehensive care for our members.

Responsibilities

• Partner with the Social Worker to assess a member's home health and level of care needs.
• Assist members in accessing necessary covered services and provide referrals.
• Coordinate other medical services in support of the member-centric service plan.
• Perform comprehensive assessments in the member's home to evaluate appropriateness for Managed Long-Term Care (MLTC).
• Develop and maintain a person-centered service plan based on needs assessments.
• Review financial, legal, or medical issues and refer members to social work or other professionals.
• Ensure documentation in the care management record meets all applicable professional standards.
• Identify early signs of problems or significant changes in member conditions to initiate early intervention.
• Competently use the UAS-NY assessment tool.

Requirements

• Current New York State Registered Nurse License
• Valid NYS Driver's license
• BSN or AAS Degree or diploma in Nursing (Preferred)
• Minimum of three (3) years nursing experience in home care, case management, discharge planning or managed care
• Minimum of one (1) year experience working with a frail or elderly population
• Minimum one (1) year experience with health assessments
• Demonstrated favorable interpersonal and assessment skills
• Familiarity with governmental and accrediting agency health plan requirements
• Knowledge of clinical criteria for determining medical necessity and/or benefit administration
• HIPAA Privacy compliance
• Computer skills, including working knowledge of Electronic Medical Records (EMR) and Microsoft Office Suite (365)

Nice-to-haves

• Case Management Certification (Preferred)
• Experience with UAS-NY assessment tool (Preferred)

Benefits

• Health insurance
• Dental insurance
• Paid time off
• Vision insurance
• 401(k) matching
• Life insurance
• Referral program