Registered Nurse Care Manager – MLTC

CareSource

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

Posted 10/28/2026full-timeQueens • New York • United StatesJuniorMid-Level💰 $100,000 - $135,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care coordination, including in-home assessments, service authorization, and interdisciplinary collaboration to support independent living for members. Proficient in navigating healthcare laws and case management standards while ensuring compliance and effective documentation.

Highest-signal resume keywords

Registered Nurse LicensureCare CoordinationCase Management CertificationHealthcare Laws KnowledgeBilingual Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

In-Home AssessmentCare ManagementPatient Centered Service PlansEligibility AssessmentDocumentation of Care ManagementCritical ThinkingDecision-MakingProblem-SolvingOrganizational SkillsTime Management

Soft Skills

Critical ListeningCollaborationAdvocacy

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicensureCase Management Certification

Industry Keywords

Healthcare ContinuumInterdisciplinary TeamGeriatricsManaged Long-Term CareCMSA Standards

About the role

Key responsibilities & impact

Provide care coordination through 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
Support the most independent living situation possible for members
Manage care across hospital, sub-acute, long-term and home settings
Assess ongoing eligibility for services based on plan criteria
Perform home visits to assess living situations, cultural influences, functional needs and cognitive needs
Collaborate with physicians and the Inter-Disciplinary Team to develop Patient Centered Service Plans
Ensure safe and appropriate member discharges
Identify, investigate and document same-day grievances
Present complex or difficult-to-manage 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 job-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
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
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 clearance of a driver's license record check required
Annual influenza vaccination required during influenza season
Must reside in the assigned territory
Ability to travel greater than 50% of the time
Flexible availability, 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 to different work locations