Compass Healthcare Consulting and Placement is currently seeking an experienced Registered Nurse for a Hybrid RN Care Management Team Lead opportunity working for Managed Care Plans. Position is hybrid, 2 days remote and 3 days in-office in Manhattan, NY. Qualified candidates must have NYS-RN License, UAS-NY Certification and previous supervisory experience, RN Care Management, Documentation Review and MLTC experience. Must be able to commute to Manhattan, NY 3 days per week.

The RN Care Management Team Leader is responsible for the clinical supervision of the Care Management Teams and the overall team unit performance in order to carry out duties and contract specific requirements.

Qualifications:

RN (BSN Preferred) with current, valid, and unencumbered license, certificate, or registration or credentialing as required.

5 years of clinical experience with one year of home health experience.

MS Office proficiency, excellent verbal and written communication, and the ability to work well under pressure required.

Must maintain all state and federal compliance requirements for licensure and employment.

Additional Requirements: Bi-lingual, UAS certified, and knowledge of care management preferred.

Essential Job Responsibilities:

• Must become proficient in article 49 regulation.

• Responsible for service authorizations, creates care plans, and coordinates services throughout the continuum of care for high-risk populations.

• Assesses and coordinates Hospitalization / Skilled Services CHHA /Nursing Home Communication and Planning.

• Coordination of Benefits for Medicare, Medicaid, Other insurance.

• Coordinates transitional care management (acute to home, home to skilled nursing facility SNF/custodial, home to hospital and acute to SNF/custodial.

• Completes Monthly Call Assessments and follows up on calls triggered by changes in meds, diagnosis or events such as ER visits, falls, etc.

• Coordinates post-discharge services as needed.

• Conducts managed long-term care quality measure planning and implements evidence based clinical pathways.

• Collaborates with Clinical Consultant Team on issues requiring additional psychosocial and clinical guidance for complex member needs. Examples include end of life care planning, acute condition management, completion of POA, health proxy, or guardianship documentation.

• Documents all findings and interventions.

Competitive salary, benefits and generous PTO package.

Salary $120,000.00 - $125,000.00 per year, based on exact experience

Qualified Candidates Please Apply Now for Immediate Consideration
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