Trabajos remote nurse case manager en New Rochelle, New YorkCrear alertas

RN Case Manager – MLTC (Bilingual highly preferred) – Hybrid (4 days remote) Job Summary: 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. Essential Functions: • 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., • 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 Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel, • Ability to communicate effectively with a diverse group of individuals, • Ability to multi-task and work independently within a team environment, • Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices, • Adhere to code of ethics that aligns with professional practice, • Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice, • Strong advocate for members at all levels of care, • Strong understanding and sensitivity of all cultures and demographic diversity, • Ability to interpret and implement current research findings, • Awareness of community & state support resources, • Critical listening and thinking skills, • Decision making and problem-solving skills, • Strong organizational and time management skills, • Bilingual speaking and writing skills are preferred Licensure and Certification:, • Current, unrestricted Registered Nurse licensure in the state of New York required, • Case Management Certification preferred Working Conditions:, • General office environment; may be required to sit or stand for extended periods of time #AC1 #ACP

Job Description WOMENS HEALTH NURSE PRACTITIONER Full Time New York, NY The “TRUE HEALTH” is a for-profit healthcare organization with 7 health centers, providing primary care and preventative medicine in the following locations in Nassau County, Queens, and Brooklyn. As privately qualified health centers, we serve the individuals in our communities, providing enhanced services, expanded hours and reduced prescription pricing, while raising the level of care. We treat patients regardless of income, residency, or immigration status. The TRUE HEALTH offers a stable employment opportunity with a growing company, and competitive base compensation along with health and dental insurance, paid time off, 401-K with company match, paid holidays, employee discounts and much more. Our Mission The mission of TRUE HEALTH is to provide access to equitable, comprehensive, optimal healthcare by improving the overall wellness of all individuals in our communities and delivering high quality extensive patient centered care. Our Vision Creating healthier communities by transforming the health care system one person at a time. JOB TITLE: Nurse Practitioner REPORTS TO: Chief Medical Officer/Administrative Manager/Medical Director The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the essential functions of the job and should not be considered as a detailed description of all the work requirements of this position. About the Role: The Women's Health Nurse Practitioner (WHNP) plays a crucial role in providing comprehensive healthcare services to women across their lifespan. This position focuses on promoting health, preventing disease, and managing various health conditions specific to women. The WHNP will conduct thorough assessments, develop individualized care plans, and provide education to empower patients in making informed health decisions. Collaboration with other healthcare professionals is essential to ensure a holistic approach to patient care. Ultimately, the WHNP aims to enhance the overall well-being of women in the community through compassionate and evidence-based practices. Minimum Qualifications: • Master's degree in Nursing with a specialization in Women's Health., • Current Nurse Practitioner license and certification in Women's Health., • Minimum 1 year experience as NP, • Graduated from approved Nurse Practitioner Program., • Licensed as Nurse Practitioner in New York State., • Basic CPR (BCLS) certification required., • Specialty Certification Preferred., • Bilingual in English and Spanish or Creole preferred., • Experience in telehealth services and remote patient management., • Familiarity with electronic health record (EHR) systems., • Conduct comprehensive health assessments and physical examinations for female patients., • Diagnose and manage acute and chronic health conditions, including reproductive health issues., • Provide counseling and education on topics such as family planning, prenatal care, and menopause management., • Collaborate with interdisciplinary teams to develop and implement patient-centered care plans., • Maintain accurate and up-to-date patient records in compliance with healthcare regulations., • Involved with direct patient physical assessment, education, and health planning., • Assists in the coordination of services with other disciplines and patient’s insurance plans., • Advocates for patient in arrangement of medically necessary services., • Communicates with community’s resources to ascertain adequate assistance for patients in need., • Refers patients to specialty services when necessary., • Consults with collaborating physician and other members of the health care team to establish plan of care., • Participate in LEAN and other activities necessary to implement the multi-disciplinary patient-centered medical home approach for the care of patients, • Maintains continuity of care by regular patient follow-up., • Participates in quality assurance process to assure optimal care delivery., • Provides comprehensive case management services that include emphasis on health promotion and disease prevention., • Monitors patient outcome in accordance with the practice protocols;, • Collaborates with staff nurses and nursing administrators with assessment and clinical decision in patient care planning., • Acts as a resource person for the nursing staff., • Conducts education in service on practice issues. The required skills for this role include advanced clinical assessment and diagnostic skills, which are essential for accurately identifying health issues in female patients. Strong communication skills are vital for effectively educating patients about their health and treatment options. The ability to collaborate with a diverse healthcare team enhances the quality of care provided to patients. Preferred skills, such as proficiency in telehealth, allow the WHNP to reach a broader patient base and provide care in a flexible manner. Overall, these skills contribute to a supportive and effective healthcare environment that prioritizes women's health. SALARY: Commensurate with experience MORE INFORMATION: This is an exempt position. The TRUE HEALTH provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, gender, marital status, sexual preference, and orientation, or non-disqualifying physical or mental handicap/disability in each aspect of the human resources function. Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The TH shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.

Job Description The MA Principle Care Management (PCM) Program Manager is responsible for overseeing the PCM program, ensuring high-quality, patient-centered care for individuals with chronic conditions. This role involves managing a team of medical assistants, coordinating care services, monitoring compliance with healthcare regulations, and implementing best practices to improve patient outcomes. Key Responsibilities: * Manage, implement, and oversee the PCM program to ensure effective care coordination for patients with chronic conditions. * Supervise and lead a team of medical assistants, providing guidance, training, and performance evaluations. * Monitor and ensure compliance with CMS guidelines and other regulatory requirements. * Collaborate with physicians, nurses, and other healthcare providers to optimize patient care plans. * Maintain accurate patient records, ensuring timely documentation and reporting. * Establish and track key performance metrics to measure program effectiveness and identify areas for improvement. * Serve as a point of contact for patients, families, and caregivers to address concerns and provide education about PCM services. * Develop and implement workflows, policies, and procedures to enhance program efficiency. * Stay updated with industry trends and regulations to ensure continuous improvement and compliance. * Facilitate team meetings, case reviews, and interdisciplinary discussions to enhance patient outcomes. Qualifications: * Active Medical Assistant license * 2 years in care management or chronic care coordination. * Experience in a supervisory or leadership role preferred. * Strong understanding of CMS regulations related to PCM and chronic care management. * Excellent leadership, communication, and organizational skills. * Proficiency in electronic health records (EHR) systems and documentation. * Ability to work collaboratively in a multidisciplinary healthcare environment. * Strong problem-solving and critical-thinking abilities. Work Environment: * Office-based with 1 day working remote * Standard business hours with potential for occasional evening or weekend work based on program needs. This position offers a unique opportunity for an experienced RN to lead a care management program focused on improving the health and well-being of patients with chronic conditions. If you are a dedicated nurse leader with a passion for care coordination and team management, we encourage you to apply. Powered by JazzHR HuON4FdHuW

Job Description The RN Principle Care Management (PCM) Program Manager is responsible for overseeing the PCM program, ensuring high-quality, patient-centered care for individuals with chronic conditions. This role involves managing a team of medical assistants, coordinating care services, monitoring compliance with healthcare regulations, and implementing best practices to improve patient outcomes. Key Responsibilities: * Manage, implement, and oversee the PCM program to ensure effective care coordination for patients with chronic conditions. * Supervise and lead a team of medical assistants, providing guidance, training, and performance evaluations. * Monitor and ensure compliance with CMS guidelines and other regulatory requirements. * Collaborate with physicians, nurses, and other healthcare providers to optimize patient care plans. * Maintain accurate patient records, ensuring timely documentation and reporting. * Establish and track key performance metrics to measure program effectiveness and identify areas for improvement. * Serve as a point of contact for patients, families, and caregivers to address concerns and provide education about PCM services. * Develop and implement workflows, policies, and procedures to enhance program efficiency. * Stay updated with industry trends and regulations to ensure continuous improvement and compliance. * Facilitate team meetings, case reviews, and interdisciplinary discussions to enhance patient outcomes. Qualifications: * Active RN license * Bachelor's degree in Nursing (BSN) preferred. * Minimum of 3-5 years of clinical nursing experience, with at least 2 years in care management or chronic care coordination. * Experience in a supervisory or leadership role preferred. * Strong understanding of CMS regulations related to PCM and chronic care management. * Excellent leadership, communication, and organizational skills. * Proficiency in electronic health records (EHR) systems and documentation. * Ability to work collaboratively in a multidisciplinary healthcare environment. * Strong problem-solving and critical-thinking abilities. Work Environment: * Office-based with 1 day working remote * Standard business hours with potential for occasional evening or weekend work based on program needs. This position offers a unique opportunity for an experienced RN to lead a care management program focused on improving the health and well-being of patients with chronic conditions. If you are a dedicated nurse leader with a passion for care coordination and team management, we encourage you to apply. Powered by JazzHR QsXTSluX7f