Behavioral Health Registered Nurse (RN) Care Manager

CareSource

Nurse Care Manager providing care coordination and management in behavioral health for members in Queens, NY. Collaborating with healthcare teams to promote quality outcomes and independent living.

Posted 5/6/2026full-timeQueens • New York • 🇺🇸 United StatesMid-LevelSenior💰 $100,000 - $135,000 per yearWebsite

About the role

Key responsibilities & impact

The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost effective outcomes.
Ensures consistent care along the entire health care continuum by assessing and closely monitoring members’ needs and status.
Authorizes covered services and coordinates care regardless of payer.
Collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team.
Works with member/family to maintain the most independent living situation possible.
Assesses, plans and provides continuous care management across all venues of care, including hospital, sub-acute, long-term and home settings.
Regularly assesses members for ongoing eligibility for services based on the specific plan’s eligibility criteria.
Performs home visits as required to assess members’ living situation, cultural influences, functional and cognitive needs.
Collaborates with the primary care physician and Inter-Disciplinary Team (IDT) to develop the Patient Centered Service Plan for the member.
Ensures appropriate, safe plan for members’ discharge from their plan.
Identifies same day grievances, investigates and documents accordingly.
Documents any grievance according to plan policy.
Identifies and presents members with complex care management needs or in difficult to manage situations at Intensive Care management meetings (ICM).
Responds to members’ requests in the designated timeframes and completes Initial Adverse Determinations (IAD) as indicated.
Identifies members requiring Care Management Review (CMR), evaluates documentation provided by the IDT including hospital or nursing home discharges planners, and formulates appropriate plan of care.
Documents care management/coordination according to company policy to the specific plan the member is enrolled in, which may include monthly telephonic and in person recertification notes.
Develops efficient plans of care, authorizing only needed services at the most appropriate levels, utilizing network providers and ensuring that services are based on members’ needs.
Perform any other job related duties as requested.

Requirements

What you’ll need

Associates degree in Nursing from an accredited nursing program required
Bachelor's degree in Nursing preferred
Three (3) years of experience as a registered nurse required
Clinical experience in geriatrics and/or managed long-term care experience preferred
Experience using multiple languages may be required based on operational needs

Benefits

Comp & perks

comprehensive total rewards package

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

care coordinationin-home assessmentcare managementpatient centered service planeligibility assessmentgrievance documentationcare management reviewtelephonic recertificationfunctional assessmentcognitive assessment

Soft Skills

advocacycollaborationcommunicationplanningmonitoringproblem-solvingorganizational skillsinterpersonal skillsindependent living supportinvestigation

Certifications

Associates degree in NursingBachelor's degree in Nursing