Case Management RN

Location: Brooklyn, NY
Date Posted: 09-12-2018
Dual Eligible Case Management RN - Managed Long Term Care (MLTC)
New York, NY (Brooklyn)
* 100% Telephonic Case Management - In Office for first 3 months, then Work-From-Home 2-3 days/week! *
** Earn a $2,500 bonus at 6 months and again after 1 year of Employment! **

Case Manager Job Summary:
  • The RN Case Manager will be responsible for the development of patient focused care delivery plans, along with coordinating, monitoring and evaluating the execution of the plans. 
  • The Case Manager will act as a patient advocate and navigator by facilitating continuity of patient care and care transitions with external healthcare organizations and facilities. 
  • Leads the Inter-Disciplinary Team (IDT) which provides each participant with an individualized, comprehensive care plan designed to maximize and maintain individual’s functional potential and quality of life. 
  • Authorizes and manages the clinical and customer service decisions relating to the case management and services provided to FIDA participants. 
  • Provides telephonic medical case management to members. 
  • Ensures all services provided are in compliance with policies and procedures as well as applicable state and federal regulations, while at the same time balancing clinical and customer service concerns. 
Case Manager Background: 
  • Valid, unrestricted state Registered Nurse (R.N.) license. 
  • Bachelor’s degree in Nursing (BSN) and/or Certification in Case Management (CCM) is preferred.
  • 2-4 years acute care clinical nursing experience.
  • At least 3 years of experience in a managed care organization working with Medicare and Medicaid guidelines, including familiarity with Medicare Part A, B, and D, required. 
  • Prior experience working with regulators, medical, behavioral health and social service providers and all levels of staff to care manage and coordinate services required. 
  • Demonstrated understanding of a fully capitated program from a regulatory perspective for care management and the ability to apply capitation to care management practice required. 
  • Working knowledge of FIDA model of care required. 
  • Familiarity with NY State assessment tools preferred. 
  • Experience in utilization review with strong cost containment/case management background required. 
  • Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills required.  
Erik Berg
443.470.8240 (CALL – TEXT – FAX)
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