Infojini Healthcare is seeking a travel nurse RN Care Manager for a travel nursing job in New York, New York.

Job Description & Requirements

• Specialty: Care Manager
• Discipline: RN
• Start Date: 01/13/2025
• Duration: 13 weeks
• 40 hours per week
• Shift: 8 hours, days
• Employment Type: Travel

HYBRID JOB CONTRACT ROLE (JAN START)
Job Title: RN Care Manager ED
Duration: 13 weeks contract assignment with extension
Shift: Hybrid 9-5 M-F
Required Education, Training & Professional Experience:
- High School Diploma General Equivalency Diploma (GED) required; and
- 2-5 years’ clinical experience in an acute or applicable care setting.
- UM/UR experience in managed care or hospital setting required.
SCOPE OF ROLE & RESPONSIBILITIES:
- Performs review of letters for Article 44 compliance, generates Lack of Clinical information letters, and
ancillary services review, etc., following established MetroPlusHealth Utilization Management policies,
procedures, and protocols.
- Oversee the coordination and delivery of comprehensive, quality healthcare and services for all members
requiring care management in a cost-effective manner.
- Interacts and obtains relevant clinical information from members’ PCP and other providers; approves care
that meets established criteria; and refers all other cases to the MetroPlusHealth Physician
Advisor/Medical Director.
- Informs member and provider of Utilization Management determinations and
treatment alternatives.
- Identifies utilization trends and potential member needs by means of generating reports of encounter data,
pharmacy data review, and new member health assessment forms.
- Evaluate member needs for referred cases (from providers or member self-referred).
- Assists all departments with the resolution of members’ problems related to utilization management
issues.
- Performs all Utilization Management activities in compliance with all regulatory agency requirements.
- Conducts medical record reviews as appropriate to case management functions.
- Participate in Medical Management grand rounds with the Physician Advisor.
- Performs all other duties as assign
The Care Manager, under the direction of the Vice President of Clinical Services, is primarily responsible for
managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize
unnecessary medical expenses, through the coordination of services, both outpatient and inpatient. The Care
Manager will assist the provider in directing care to the most appropriate setting, evaluating alternative care plans,
and assessing outcomes through outreach to the members.

Infojini Healthcare Job ID #33890985. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined.

About Infojini Healthcare