One of the region's fastest-growing health plans is looking for an experienced Registered Nurse Case Manager who is seeking an exceptional career opportunity with the benefit of working from the comfort of his/her own home.
After training in the Manhattan headquarters, this position will telecommute from your home with the exception of mandatory onsite meetings and training.
In this position you will:
- Manage patient care with special needs members, their families, or significant others and coordinate with the PCP and all members of the health care team to facilitate the patient's care across continuums of care episodes
- Perform preadmission and concurrent and retrospective reviews to evaluate appropriateness of admission, need for continued stay, length of stay, utilization of resources, patient outcomes, and usage of other services post-encounter
- Be responsible for compliance, in practice, with regulatory mandates
- Facilitate member transfer to hospitals
- Document all interventions and telephone encounters with providers, members, and vendors in the appropriate system in accordance with established documentation standards to insure integrity of member services
- Assess member's physical, psychological, and discharge planning needs through communication with appropriate hospital staff including attending practitioner, utilization review staff, discharge planners, social workers, and then coordinate care accordingly
Please be advised that we are only considering nurses with the following:
- Current RN Licensure in New York State
- Associates Degree in Nursing
- Minimum 2 years clinical nursing experience
- Minimum 3 years case management and utilization review experience
- Experience working with NY Medicaid and the special needs population
- Knowledge of the concepts and philosophy of case management, utilization review regulations, and relevant medical standards of practice, especially for special needs populations
- Proficiency with spreadsheet software and word processing systems
- Must reside within 50 mile radius of job location to be eligible for telecommuting position
What is it really like to work for one of the fastest growing health plans?
Here’s what others have to say...
"I enjoy the flexibility my position affords me."
"The company has shown me they care about me as an individual."
"I like working here because of the competitive salary and benefits offered."
"I enjoy working with my colleagues and bosses. I am respected as an individual and as a professional."
Generous Benefits Including Performance Bonus!
This rapidly growing award winning managed care organization is committed to maintaining a challenging environment that promotes personal growth and an active and rewarding role in fulfilling the goals of the organization. They recognize that Registered Nurse Case Manager is a critical part of providing affordable quality care to its members and are happy to offer the individual in this position these generous benefits:
* 23 days paid time off
* Choice of three medical plans, plus dental and vision
* 403(b) retirement and 401(k) with company match
* Flex spending account
* Short term and long term disability
* Life insurance
* Performance bonus
How Pathway Medical Works with You to Get the Job
Since 1998 we have focused exclusively on helping case managers and related non-bedside nursing professionals find career opportunities that fit their lifestyle and advance their careers.
* We have long standing relationships with nurse executives at dozens of leading healthcare organizations, ensuring that your accomplishments and skills get noticed by key decision makers.
* We will review your resume to make certain it emphasizes the important skills and experience requirements of the job for which you are applying.
* We will then prepare you for your interview , enabling you to show why you are the best candidate for the job.
* When an offer is extended we will help you negotiate compensation, benefits and any additional employment issues.
Pathway Medical Staffing - 10 months ago
Since 1998 Pathway Medical Staffing has placed case managers and non-bedside nurses in great jobs at hundreds of leading healthcare...