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RN Care Manager (HYBRID)

US Family Health Plan- A TRICARE Prime option
New York, NY Full Time
POSTED ON 1/13/2025 CLOSED ON 2/8/2025

What are the responsibilities and job description for the RN Care Manager (HYBRID) position at US Family Health Plan- A TRICARE Prime option?

JOB SUMMARY


Nurse Care Manager is a practice-based Registered Nurse who collaborates with members of the health care team to coordinate an individualized plan of care for Members in the community. The Nurse Care Manager communicates with Members/caregivers to assess their needs and then consults with health professionals to decide on which services /interventions to provide.


RESPONSIBILITIES
  • Addresses member’s problems and needs from a clinical, psychosocial, financial and environmental stand point.
  • Provide services to members of varying age, risk level, clinical scenario, culture, financial means, social support, and motivation.
  • Engage members in a collaborative relationship, empowering them to self-manage their physical, psychosocial and environmental health to improve and maintain lifelong well-being.
  • Prepare member-oriented plan of care with member, caregivers, and health care providers, integrating concepts of cultural sensitivity and privacy practices.
  • Participates in interdisciplinary meetings.
  • Ensure plans of care have individualized goals and interventions.
  • Discusses Members’ plan of care to Primary Care Physician and/or Medical Specialists.
  • Address gaps in care with the member/caregiver and provider.
  • Addresses members social determinants of health issues.
  • Link members to available community resources.
  • Provide care management support during Transitions of Care
  • Ensure member/caregiver understanding as it relates to language barriers and stress reaction or cognitive limitations/barriers.
  • Educates Members on relevant chronic diseases, preventive care, medication management (medication reconciliation and adherence), home safety, etc.
  • Provide Complex care management including but not limited to; ensuring access to care, reducing unnecessary hospitalizations, and appropriately referring to community supports.
  • Advocate for members by assisting them to address challenges and make informed choices regarding clinical status and treatment options.
  • Maintain accurate, comprehensive and current clinical and non-clinical documentation in USFHP’s computer data base.
  • Employ critical thinking and judgment when dealing with unplanned issues
  • Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies and procedures, and actively participate in the evaluation process.

 

EXPERIENCE


  • Minimum 2 years care management experience required
  • Medical Surgical Nursing Experience


Skills/Competencies

·      Care Management

·      Communication skills

·      Time management

·      Teamwork

·      Problem-solving

·      Strong critical thinking skills


Education/Certifications/License

  • Bachelor’s Degree required
  • Must possess a current and unrestricted NYS RN License and Registration. Must be willing to get licensed in CT, PA, and NJ.


Salary Range:

95,000 - 100,000


SVCMC IS AN EQUAL OPPORTUNITY EMPLOYER - ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN, DISABILITY OR VETERAN STATUS. 


Salary : $95,000 - $100,000

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