Local Contract Nurse RN - Care Manager
New York, NY
Prokatchers
5x8 hrs, Days

Pay Rate: $55.00/hr.

Medical Specialty: Managed Long Term Care

Standard Shift: Days

Weekly Schedule: 5x8

Shift Timings: 09:00 AM - 05:00 PM, Hybrid role.

Description:
The Care Manager develops, facilitates, monitors, and communicates a care plan in partnership with the member, their family or significant other, primary caregiver, the primary and/or the attending physicians, and various providers.
Using the assessments and interview done by the Assessment Nurse, the Care Manager identifies the risk factors, strengths, challenges, and service needs of the member as they strive to keep them safe and well in their community setting.

Job Duties:
Review and evaluate the assessment and UAS information for members in the MLTC and MAP lines of business.
Develop a working relationship with the PCP to be able to contact and discuss the care of the member with them.
Review assessment findings with the PCP to identify any concerns that have not been identified by the clinical team.
Identify the risk factors and assign the risk category to the member.
As part of Care Management team, develops a formal care plan for all services needed for the member, including the member’s disaster plan.
Monitor the condition of all members at least monthly, typically by telephone but via face-to-face when necessary.
Identify clinical issues that require immediate clinical assessment and/or treatment to reduce risk of unnecessary hospitalizations, ED visits or nursing home admissions.
Identify opportunities to improve the quality of care by ensuring members receive needed preventative and chronic disease care.
Prior approve request for additional services based on assessments and using evidencebased standards refer denial, reduction, or limitation of service request to Medical Director.
Assist members with the coordination of services both within and outside networks as appropriate.
Includes facilitating discharge from acute setting and alternate settings.
Provides Care Coordination through continuum of care.
Optimizes both the quality of care and the quality of life for the MetroPlusHealth members.
Coordinate with Utilization Management (UM) department on concurrent and retrospective review.
Follow up with assigned nurses for clinical updates to care plan.
Document within two business day’s coordination notes and routine contacts with the members according to the level of risk assigned to them.
Participate in team care planning meetings.
Handles complains that can be resolved in one day.
Assists Customer Service and the UM department by providing records and materials needed for grievances from MLTC/MAP program members.
Speaks to members who are delinquent in their spend-down payments.
Cooperates with all department within MetroPlusHealth.
Identifies members appropriate for specialty programs.
Performs all MLTC/MAP management activities in compliance with all regulatory agency requirements.
Provides information on all requests from Quality Management Department to be reviewed by the various Quality committees.
Completes all other tasks assigned by MLTC Dept. Leadership.
Participates in the department on call schedule/being on call, which is rotated amongst the care team.

Education Required:
Bachelor’s Degree required; BSN preferred.

Experience Required:
Two (02) to three (03) years clinical experience in certified home health agency (CHHA), Lombardi program and/or MLTC or MAP program.
Five years minimum of clinical experience as a Registered Nurse.
Experience with Care Coordination, Utilization review and discharge planning Computer literacy required.

Certifications & Licenses:
RN Licensed as a Registered Nurse in the State of New York required.
PRI and Screen certification within three months of employment is required.

Preferred Skills:
Master’s Degree and Bilingual Spanish Certification in Case Management preferred.
Leadership experience preferred.

ProKatchers LLC is revolutionizing healthcare staffing! ProKatchers LLC has been recognized as one of the fastest-growing healthcare staffing companies in the country by Staffing Industry Analysts, real travel nurses, and allied healthcare professionals that work with our team. Our focus is on empowering our healthcare professionals to deliver exceptional patient care experiences. We're dedicated to making your travel healthcare journey easy by taking care of all the details, so you don’t have to.

Our goal is to positively impact the healthcare industry by providing a truly comfortable experience as you explore your travel nursing, therapy, or allied career. Our responsive and friendly recruiters prioritize our clinicians in fulfilling their dream and mission of improving lives by providing quality patient care.

If you don’t have this kind of relationship with your current recruiter and travel nurse agency, maybe it’s time you try one that’s a little bit different and join us in making a difference!

Mission Statement:
We are on a mission to help others live better and we do this by helping the healers of the world be as comfortable as possible.

The Onboarding Process You Deserve:
Looking for a travel nursing company that's got your back every step of the way? Look no further than ProKatchers LLC. Our recruitment specialists are the most detailed in the industry, and we work tirelessly to ensure your onboarding process is stress-free.

We understand that contract transparency is a major concern for nurses, especially when navigating unfamiliar hospital systems with complex pay packages and different rules for each assignment, but don't worry, ProKatchers has got you covered! We have several policies in place to prevent confusion about what's expected from nurses before they begin a contract.

Choose ProKatchers LLC for the onboarding process you deserve.!