RN Care Manager – UAS | Long-Term Temporary Contract

RN Care Manager – UAS | Long-Term Temporary Contract Location: New York City, NY Schedule: Hybrid Pay Rate: $58–$60 per hour Assignment Type: Long-Term Temporary Setting: Hospital Contract Position Overview We are seeking an experienced Registered Nurse Care Manager to join a healthcare team supporting MLTC and MAP populations. The Care Manager develops, facilitates, monitors, and communicates individualized care plans in partnership with members, caregivers, physicians, and interdisciplinary providers. Utilizing assessment findings and UAS information, the Care Manager identifies risk factors, strengths, challenges, and service needs to support members in maintaining their health and independence within the community. Responsibilities • Review and evaluate assessment and UAS information for members in the MLTC and MAP lines of business. • Establish and maintain collaborative relationships with Primary Care Physicians (PCPs). • Review assessment findings with PCPs and identify concerns requiring clinical intervention. • Identify member risk factors and assign appropriate risk categories. • Develop comprehensive care plans, including disaster preparedness plans. • Monitor member status at least monthly through telephone outreach and face-to-face visits when necessary. • Identify clinical issues requiring immediate assessment or treatment to reduce avoidable hospitalizations, emergency department visits, and nursing home admissions. • Promote preventative care and chronic disease management to improve quality outcomes. • Review and authorize requests for additional services based on assessments and evidence-based standards; refer denials, reductions, or limitations of services to the Medical Director. • Coordinate services both within and outside the network as appropriate. • Facilitate transitions of care, including hospital discharge planning and coordination with alternative care settings. • Provide care coordination throughout the continuum of care. • Collaborate with Utilization Management on concurrent and retrospective reviews. • Follow up with assigned nurses regarding clinical updates to care plans. • Document care coordination activities and member contacts within two business days, according to assigned risk levels. • Participate in interdisciplinary care planning meetings. • Resolve member complaints that can be addressed within one business day. • Support Customer Service and Utilization Management departments with records and documentation needed for grievance investigations. • Communicate with members regarding spend-down payment compliance. • Collaborate with internal departments to ensure effective member care and service delivery. • Identify members who may benefit from specialty programs. • Ensure compliance with all MLTC/MAP regulatory requirements. • Assist Quality Management with requests and reporting needs. • Complete additional duties as assigned by department leadership. • Participate in a rotating on-call schedule. QualificationsRequired • Active Registered Nurse (RN) license in New York State. • Bachelor's degree required. • Minimum of five (5) years of clinical nursing experience. • Experience with care coordination, utilization review, and discharge planning. • Strong computer and documentation skills. • PRI and Screen Certification required within three months of employment. Preferred • Leadership experience. • Master's degree. • Bilingual Spanish. • Case Management Certification. Compensation and Benefits • Competitive pay rate of $58–$60 per hour. • Hybrid work schedule. • Long-term contract opportunity. • Collaborative healthcare environment. • Opportunity to make a meaningful impact on patient outcomes and quality of care. Apply today to be considered for this exciting RN Care Manager opportunity in New York City. #PHAXISGONUL Pay: $58.00 - $60.00 per hour Work Location: In person