RN Care Manager at Mercy Health responsible for coordinating patient care and transitions. Focus on holistic management of patient health needs and collaboration with healthcare teams.
About the role
- Care Manager at Healthfirst coordinating physical and behavioral health care for diverse members. Engaging with clients, developing care plans, and collaborating with healthcare teams to improve outcomes.
Responsibilities
- Plans, manages, and coordinates physical and behavioral care
- Supports a variety of areas including the Recipient Restriction Program (RRP)
- Conducts medical reviews of member usage patterns
- Participates in RRP Committee meetings
- Advocates and educates beneficiaries on services and self-management techniques
- Develops care plans that align with the physician’s treatment plans
- Generates referrals to providers and community-based resources
- Coordinates care with the multi-disciplinary health care team
- Evaluates service authorizations and updates care plans
Requirements
- NYS RN
- Strong interpersonal and assessment skills
- Ability to relate well with seniors and their families
- Fluency in Spanish, Korean, Mandarin, or Cantonese
- Knowledge and experience with current community health practices for frail adults
- Knowledge of InterQual and LOCADTR
- Experience managing member information in a shared network environment
- Demonstrated ability to manage large caseloads
- Proficient with Microsoft Excel
Benefits
- medical, dental and vision coverage
- incentive and recognition programs
- life insurance
- 401k contributions
Job title
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