RN Care Managers - Korean, Spanish Speaking
Integra Managed Care - Brooklyn, NY

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Department: Care Management
Reports to: Care Management Supervisor
Fulltime, Office-based

The Care Manager is an integral part of Integra’s Care Management Team. The Care Manager works in conjunction with the medical social worker, and a service coordinator. All members of the care management team interact with the member, thereby assuring continuity for the member in the delivery and coordination of services.

Essential Job Duties:

  • Develops and updates individualized care plan based on comprehensive assessment of members in consultation with the member and family/caregiver and the assessment nurse;
  • Implements the care plan and authorizes/arranges for delivery of covered services consistent with the care plan;
  • Conducts ongoing communication and collaboration with member, family caregiver, or member’s designated representative, as well as with member’s PCP and other significant health care providers;
  • Monitors provision of services by Integra’s network providers to ensure they are appropriate and in accordance with the member’s care plan;
  • Conducts ongoing monitoring of member’s health, safety, and functional status, and progress towards established goals;
  • Provides coordination of care transitions, including discharge and transition planning from hospital or nursing homes;
  • Determines member eligibility for Integra’s program and quality initiatives that may include but not be limited to: diabetes management program, falls prevention program, physician home visiting program, tele-health program, etc.
  • Facilitates establishment of Advance Care Planning and assuring appropriate administration of the member’s Health Care Proxy.
  • Reviews member’s medical status and issues, identifying follow up issues;
  • Serves as primary contact with member’s PCP or specialist physicians as well as member’s long term care service providers;
  • Monitors member’s medication adherence;
  • Counsels member on his/her medical condition and provides education/coaching on self-management or care giving by family members;
  • Conducts monthly outreach to member to check on member’s status;
  • Updates member case records.
  • Participate in Quality Assurance and Improvement activities as directed by Director of Clinical Management
  • Other duties as assigned by the Care Management Supervisor and/or the Director of Care Management.

Qualifications

  • NYS license and current registration as a registered nurse;
  • Minimum of two years of experience in clinical practice;
  • Experience in managed care and/or care management preferred;
  • Experience with geriatric population preferred.
  • Preferred qualifications for a Care Manager include a Bachelor's or Master's degree in health, human or education services and one year of care management experience.