Registered Nurse Care Manager

CareSource

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

Posted 10/7/2026full-timeRemote • 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 assessment, planning, and advocacy for members across various healthcare settings. Proficient in developing patient-centered service plans and ensuring compliance with healthcare laws and case management standards.

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 CoordinationPatient AssessmentService AuthorizationPlan DevelopmentDocumentationHome VisitsEligibility AssessmentGrievance InvestigationDecision-MakingProblem-Solving

Soft Skills

Critical ListeningOrganizational SkillsTime ManagementCollaborationAdvocacy

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicensureCase Management Certification

Industry Keywords

Healthcare ContinuumInterdisciplinary TeamPatient Centered Service PlansCommunity Support ResourcesManaged Long-Term Care

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 health care continuum
Authorize covered services and coordinate care regardless of payer
Collaborate with members, families, caregivers, primary care practitioners and the interdisciplinary team
Support members and families in maintaining the most independent living situation possible
Manage continuous care across hospital, sub-acute, long-term and home settings
Assess ongoing eligibility for services based on plan-specific criteria
Perform home visits to assess living situations, cultural influences, and functional and cognitive needs
Collaborate with the primary care physician and 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, authorize needed services at appropriate levels, utilize network providers and ensure services meet members' needs
Perform other related duties as requested

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
Must have valid driver's license, vehicle and verifiable insurance
Successful clearance of a driver's license record check required
Annual Influenza vaccination required for designated positions during Influenza season
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 for case management practice
Ability to interpret and implement current research findings
Awareness of community and state support resources
Critical listening and thinking, decision-making and problem-solving skills
Strong organizational and time management skills
Must reside in the same assigned territory
May be required to travel greater than 50% of the time
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 with disabilities, medical conditions, or sincerely held religious beliefs
Annual Influenza vaccination provided/required for designated positions during Influenza season
Flexible hours, including possible evenings and/or weekends as needed