The RN Care Manager coordinates care management services and assures the quality of care for Integra MLTC members. The RN Care Manager collaborates with a Social Worker and Care Management Coordinator to develop a thorough plan of care that addresses the specific needs of each individual member. All members of the care management team interact with the member, thereby assuring continuity for the member in the delivery and coordination of services.
Develops and updates the individualized care plan based on a comprehensive assessment of members in consultation with the member and family/caregiver and the assessment nurse;
Implements the care plan and authorizes/arranges for delivery of covered services consistent with the care plan;
Conducts ongoing communication and collaboration with a member, family caregiver, or member’s designated representative, as well as with member's PCP and other significant health care providers;
Monitors provision of services by Integra' s network providers to ensure they are appropriate and in accordance with the member's care plan;
Conducts ongoing monitoring of member's health, safety, and functional status, and progress towards established goals;
Provides coordination of care transitions, including discharge and transition planning from the hospital or nursing homes;
Determines member eligibility for Integra's program and quality initiatives; Facilitates the establishment of Advance Care Planning and assuring appropriate administration of the member's Health Care Proxy.
Reviews member's medical status and issues, identifying follow up issues;
Serves as primary contact with member's PCP or specialist physicians as well as member's long-term care service providers;
Monitors member's medication adherence in conjunction with the RN, Care Management Supervisor
Provides education/coaching in self-management of disease processes.
Conducts monthly outreach to the member to check on member's status;
Updates member case records;
Participate in Quality Assurance and Improvement activities as directed by the Director of Care Management;
Other duties as assigned by the Care Management Supervisor and/or the Director of Care Management.
Bachelor’s degree in Nursing preferred
NYS license and current registration as a registered nurse
Minimum of one-year experience in clinical practice, case management, care management or home care
Experience in managed care and/or care management preferred
Experience with geriatric population preferred
Proficient in Microsoft Office
Integra is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind. Integra is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Integra are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, sex, sexual orientation, gender identity, national origin, veteran or disability status, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. Integra will not tolerate discrimination or harassment based on any of these characteristics. Integra encourages applicants of all ages.
Internal Number: 135253
About Integra MLTC, Inc.
Integra MLTC is a New York State-approved Managed Long-Term Care Plan designed for seniors and adults who need assistance with daily living.
The goal of managed long-term care plans is to help these individuals live safely and independently in the comfort of their own homes for as long as possible while maintaining their health and well-being. When you choose Integra MLTC, you will have a dedicated team of nurses and social workers who will work with you to ensure that all your long-term care needs are met. Even if your needs change, your dedicated team will ensure your care and services are appropriately adjusted to provide the support you need.
Assist seniors and adults who require long-term care services to live safely and independently in their homes while maintaining their health and well-being.
Through the consistent delivery of the best care and services, we aspire to be the preferred plan of choice for individuals in need of quality long-term care.
We operate in Brooklyn, Manhattan, Queens, Bronx, Staten Island, Westchester, Nassau & Suffolk Counties.