Job Description
The Nurse Case Manager is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring and evaluating care plans designed to optimize member health care.
Ensures member access to services appropriate to their health needs.
Conducts assessments to identify individual needs and a specific care manager plan.
Implements care plan by facilitating authorizations/referrals as appropriate.
Coordinates internal and external resources to meet identified needs.
Monitors and evaluates the effectiveness of the care management plan and modifies it as necessary.
Requirements:
RN license in state of NY
Minimum 2 years of experience in a managed care or MLTC setting
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