BH Nurse Care Manager – MLTC

CareSource

. Provide care coordination, including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services .

Posted 9/17/2026full-timeBrooklyn • New York • United StatesJuniorMid-Level💰 $100,000 - $135,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination, including in-home assessments, patient-centered service planning, and compliance with healthcare laws and regulations. Proficient in managing complex care cases and collaborating with interdisciplinary teams to ensure optimal patient outcomes.

Highest-signal resume keywords

Registered Nurse LicensureCare CoordinationCase Management CertificationClinical Experience in GeriatricsKnowledge of Healthcare Laws

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care CoordinationIn-Home AssessmentPatient Centered Service PlanningEligibility AssessmentDocumentation of Care ManagementDecision-Making SkillsProblem-Solving SkillsOrganizational SkillsTime-Management SkillsBilingual Skills

Soft Skills

Critical ListeningCritical ThinkingCollaborationAdvocacy

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicensureCase Management Certification

Industry Keywords

Healthcare ContinuumInterdisciplinary TeamCommunity Support ResourcesCMSA StandardsAdverse Determinations

About the role

Key responsibilities & impact

Provide care coordination, including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services
Assess and closely monitor members’ needs and status across the healthcare continuum
Authorize covered services and coordinate care regardless of payer
Collaborate with members, families, caregivers, primary care practitioners and the interdisciplinary team
Help members maintain the most independent living situation possible
Provide continuous care management across hospital, sub-acute, long-term and home settings
Assess ongoing eligibility for services based on plan criteria
Perform home visits to assess living situation, cultural influences, and functional and cognitive needs
Collaborate with physicians and the Inter-Disciplinary Team to develop Patient Centered Service Plans
Ensure safe and appropriate member discharge plans
Identify, investigate and document same-day grievances
Present complex care management cases at Intensive Care Management meetings
Respond to member requests within designated timeframes and complete Initial Adverse Determinations as indicated
Identify members requiring Care Management Review and formulate appropriate plans of care
Document care management and coordination according to company and plan policies
Develop efficient plans of care and authorize needed services at appropriate levels using network providers
Perform other related duties as requested
Travel regularly to homes, offices and other public settings, potentially more than 50% of the time

Requirements

What you’ll need

Associate degree in Nursing from an accredited nursing program required
Two (2) years of experience as a registered nurse required
Current, unrestricted Registered Nurse licensure in the state of New York required
Intermediate proficiency with Microsoft Office, including Outlook, Word and Excel
Knowledge of local, state and federal healthcare laws and regulations and company case management policies
Knowledge of Case Management Society of America (CMSA) standards
Ability to interpret and implement current research findings
Awareness of community and state support resources
Critical listening and thinking skills
Decision-making and problem-solving skills
Strong organizational and time-management skills
Valid driver's license, vehicle and verifiable insurance required
Successful driver's license record check required
Annual influenza vaccination required during influenza season
Must reside in the assigned territory
Ability to travel more than 50% of the time
Ability to work flexible hours, including possible evenings and weekends
Bachelor's degree in Nursing preferred
Clinical experience in geriatrics and/or managed long-term care preferred
Experience using multiple languages may be required based on operational needs
Bilingual speaking and writing skills preferred
Case Management Certification preferred

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Reasonable accommodations for qualified individuals
Annual influenza vaccination provided/required as a condition of continued employment
Flexible hours, including possible evenings and/or weekends
Mobile work arrangement with travel between work locations