Description:

-Provides care management for members through an interdisciplinary approach through planning, facilitation, and advocacy for support and services to meet a member's needs.

-Implements an appropriate, quality, and cost-effective plan of care that utilizes all resources available to meet the member’s needs in collaboration with the member, family, health care team, medical providers, and other community-based programs based on the UAS-NY assessment.

-Oversees caseload of managed care members.

-Performs all care management activities in compliance with all regulatory agency requirements; completes required documentation, that is clear and concise and is done in a timely manner (organizational standards).

-Responsible for coordination of health plan support staff, including LPN, Community Health Workers, and Care Coordination; provide guidance and education to efficiently manage patients using a team approach.

-Participate in departmental meetings and attend all scheduled staff meetings and training as applicable and required.

-Adhere to all state and federal privacy regulations, including HIPAA and Nascentia Health Options policies and agreements regarding confidentiality, privacy, and security.

-Communicate and collaborate effectively with potential members, their families, health plan staff, and providers.

-Acts as a liaison and member advocate.

-Demonstrates cultural competence by respecting and being responsible for the member's cultural health beliefs, language needs, and support system.

-Other duties as assigned.

Skills & Qualifications:

-Education: BSN preferred; associate degree required.

-One year of Nursing Experience is preferred or a bachelor’s degree in social work, MSW preferred.

-Current RN license and registration in NYS.

-Long-term care and/or managed care experience a plus

-Knowledge of homecare, Medicare, and Medicaid is a plus.

-Care Management Certification is a plus.

-Bilingual is a plus

-Ability to work independently and prioritize workload.

-Computer literate and working knowledge of basic computer skills and Microsoft Office programs.

-Strong communication skills, both person-to-person, virtually, and by phone.

-Ability to learn and routinely utilize the organization’s software systems to perform required job duties.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.