Case Manager, RN (Multiple Openings!)
$62,400–$117,622 year
On-site · Buffalo, New York, United States or Rochester, New York, United States
Job Summary
Conducts case management program activities per standards, identifying members meeting program criteria and coordinating education, support, coaching, and care options with providers and community resources. Partners with an interdisciplinary care team to develop comprehensive care plans, address member needs and health goals, and mitigate health care cost drivers. Applies CMSA/NCQA standards, performs assessments, opens and manages cases, uses motivational interviewing to gather essential information, facilitates collaboration among members, physicians, and other health care providers, and ensures continuity of high-quality, cost-effective care across the care continuum. Participates in value-based or multidisciplinary initiatives, maintains privacy in line with policy, and supports ongoing education and professional development. Minimum qualifications include an Associate’s degree (Bachelor’s preferred), active NYS RN or Registered Dietitian or Physical Therapist licensure, at least three years of clinical experience, and case management experience as applicable.
Required Qualifications
- Active NYS RN or Registered Dietician or Physical Therapist licensure required
- Associates degree required
- Minimum of three years of clinical experience required
- Case Management experience preferred
- Proficiency with Microsoft Office Suite
- Experience in interpreting managed care benefit plans and government program contracts (Medicare and Medicaid) preferred
- Strong communication skills
- Ability to multitask and balance priorities
- Ability to work independently on a daily basis
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