RN Care Manager

CareSource

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

Posted 10/9/2026full-timeQueens • 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, service planning, and collaboration with interdisciplinary teams. Proficient in managing care across various healthcare settings while ensuring compliance with healthcare laws and regulations.

Highest-signal resume keywords

Registered Nurse LicensureCare CoordinationCase Management CertificationPatient Centered Service PlansKnowledge of Healthcare Laws

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

In-Home AssessmentCare ManagementService AuthorizationEligibility AssessmentDocumentation of Care Management

Soft Skills

CollaborationAdvocacyCommunication

Tools & Technologies

Microsoft OfficeGeneral Office Equipment

Certifications & Qualifications

Case Management Certification

Industry Keywords

Healthcare ContinuumGeriatricsManaged Long-Term CareCMSA StandardsCommunity Support Resources

About the role

Key responsibilities & impact

Provide care coordination through in-home assessment, planning, facilitation, advocacy and authorization of covered plan services
Assess and 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 members in maintaining the most independent living situation possible
Manage care across hospital, sub-acute, long-term and home settings
Assess ongoing eligibility for services based on plan criteria
Conduct home visits to assess living situations, cultural influences, and functional and cognitive needs
Develop Patient Centered Service Plans with primary care physicians and the Inter-Disciplinary Team
Ensure safe and appropriate member discharge plans
Identify, investigate and document 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

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
Current, valid driver's license, vehicle and verifiable insurance
Successful 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
Ability to use general office equipment
Preferred: Bachelor's degree in Nursing
Preferred: Clinical experience in geriatrics and/or managed long-term care
Preferred: Case Management Certification
Preferred: Bilingual speaking and writing skills
Experience using multiple languages may be required based on operational needs

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Annual Influenza vaccination requirement and immunization verification
Reasonable accommodations for disabilities, medical conditions, and sincerely held religious beliefs
Flexible hours, including possible evenings and/or weekends