Job opening
Case Management Nurse
Filed under Staffing and Recruiting
Full job description
Job Title : RN CASE MANAGER
Location: New York, NY
Job Type: Contract
Contract: 13 Weeks with Possible Extension
Schedule: Monday–Friday, 9:00 AM–5:00 PM
Guaranteed Hours: 35 Hours/Week
Pay Range: $60–$65 per hour
Work Setting: Hybrid / Non-Patient Facing
JOB SUMMARY
Pride Health is seeking an experienced RN Case Manager to provide comprehensive case management and care coordination services. The RN Case Manager will assess member needs, develop individualized care plans, coordinate healthcare services, and collaborate with members, caregivers, providers, and interdisciplinary teams to improve quality of care and patient outcomes.
RESPONSIBILITIES
Assess and evaluate members' healthcare and support needs.
Develop, implement, and monitor individualized plans of care.
Coordinate care with members, caregivers, providers, and healthcare teams.
Perform care coordination, utilization review, and discharge planning.
Review and interpret medical records, claims data, pharmacy information, laboratory reports, and prescriptions.
Identify barriers to care and develop appropriate solutions.
Educate and support members and caregivers regarding available healthcare services.
Monitor patient outcomes and modify care plans as needed.
Connect members with appropriate healthcare and community resources.
Maintain accurate and timely case management documentation.
Promote quality outcomes and appropriate utilization of healthcare services.
Collaborate with interdisciplinary teams to ensure continuity of care.
REQUIREMENTS
Current New York State RN License.
Bachelor's Degree required.
Minimum 5 years of clinical experience as a Registered Nurse.
Minimum 2 years of experience in Case Management, Care Management, Managed Care, or a healthcare setting.
Experience with care coordination, utilization review, or discharge planning.
Strong computer and documentation skills.
Ability to read and interpret medical records, claims data, pharmacy information, laboratory reports, and prescriptions.
Strong communication and interpersonal skills.
Ability to work effectively with members and caregivers.
English proficiency required.
PREFERRED QUALIFICATIONS
Previous leadership experience.
Experience working in a Managed Care or Health Plan environment.
Master's Degree.
Bilingual Spanish certification in Case Management.
PRI and Screen certification.
SCHEDULE & WORK ENVIRONMENT
Monday–Friday
9:00 AM–5:00 PM
35 hours per week
Hybrid work environment
Non-patient-facing position
Benefits
Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Equal Employment Opportunity
Pride Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.
Fair Chance Employment
Pride Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including the California Fair Chance Act and all applicable local Fair Chance ordinances.
Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.