Nurse Case Manager II Job at SGS Consulting, New York, NY

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  • SGS Consulting
  • New York, NY

Job Description

Job Responsibilities:

  • 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care.
  • Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs.
  • Provides evidence-based disease management education and support to help the member achieve health goals.
  • Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care.
  • Provides care coordination to support a seamless health care experience for the member.
  • Meticulous documentation of care management activity in the member’s electronic health record.
  • Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition.
  • Identifies and connects members with health plan benefits and community resources.
  • Meets regulatory requirements within specified timelines.

Skills:

  • Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the CM RN role.
  • Minimum 3+ years of nursing experience
  • Minimum 2+ years of case management, discharge planning and/or home healthcare coordination experience
  • Experience providing care management for Medicare and/or Medicaid members.
  • Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.
  • Experience conducting health-related assessments and facilitating the care planning process.
  • Bilingual skills, especially English & Spanish

Education/Experience:

  • Associates of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED)
  • Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY. Additional licensure is preferred but not required. NY is not a compact state, single state licensure for NY is required.
  • Bachelor of Science in Nursing (BSN) (PREFERRED)

Job Tags

Work at office,

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