Responsible for helping members achieve a level of well-being through quality improvement functions
Perform telephonic outreach to develop a plan of care for members who need CM services
Apply guiding principles for case management practice to include assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services
Adhere to regulatory and compliance requirements, department productivity and quality metrics, and provide exceptional customer service
Requirements
Registered Nurse (RN) with active, current, unrestricted NYS license, licensed master social worker (LMSW), master’s in social work (MSW), or licensed dietician with case management experience required
Case Management Certification (CCM) required
Two (2) years of case management or clinical experience in acute medical/surgical/critical care or ambulatory setting required
Proficient computer and Windows skills required, including MS Office
Previous clinical experience in a managed care setting as a case/care manager preferred
Clinical knowledge of the health and social needs of the population served
Ability to identify barriers to a successful case management path
Excellent critical thinking and time management skills
Excellent written, verbal, and interpersonal communication skills with ability to provide exceptional customer service to external and internal customers to include telephonic interviewing of members; motivational interviewing skills a plus
Transferable knowledge, skill, and ability to complete job duties independently and proficiently
Flexibility in work schedules and assignments required
Benefits
first-class perks
full range of benefits
generous paid time off
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
case managementtelephonic outreachcare coordinationassessmentplanningevaluationadvocacyclinical experiencemotivational interviewingWindows skills