Medicaid Pediatric Nurse, Case Manager – remote (NY license) in reputed company, NY

Medicaid Pediatric Nurse, Case Manager - remote (NY license) - reputed company - reputed company, NY - work from home jobCompany: EmblemHealthJob description: Summary of Position• Provide confidential administrative support/assistance to the department; support the department in reputed company aspects of daily ops.• Ensure high-touch coordination with Office of Children and Family Services (OCFS), Local Departments of Social Services (LDSS,) and (if applicable) the Voluntary Foster Care Agency (VFCA), the member is enrolled in, for reputed company members in foster care, including reputed company and coordination of the Foster Care requirements.• Act as Subject Matter Expert with the necessary experience, expertise and knowledge of the member’s welfare system, foster care healthcare requirements and the unique reputed company needs (including resultant of trauma) of the Foster Care population.• Serve as the direct Plan contact for coordinators and service providers, responsible for monitoring access for members infoster care.Principal Accountabilities• Communicate relevant notification from LDSS coordinator reputed company a member in foster care is enrolled in the managed care plan or reputed company a reputed company managed care member is entering foster care.• Support the counties in addressing issues for managed care members in foster care.• From foster care or disenrollment from an MCO.• Collaborate with LDSS coordinator to ensure assessments are completed on time.• Assist with care coordination if member is considered unstable by HCP or LDSS; or has a chronic condition.• Report to the LDSS foster care coordinator any change in member’s status (i.e., address, health status, etc.).• Assist with discharge• Collaborate with LDSS coordinator to ensure continuity of care plans are in reputed company upon disenrollment or discharge from foster care.• Collaborate with LDSS coordinator to ensure that the LDSS and MCO (if plan transfer) are aware of the transition and reputed company care plan can be coordinated.• Participate in the development of project plans; tracking and management of projects; and departmental activities reputed company to foster care schedule and cost.• reputed company other duties as directed, requested, assigned, or required.Education, Training, Licenses, Certifications• Bachelor’s degree, preferably in Nursing.• reputed company unrestricted reputed company State RN license.• CCM certification required, or successful completion of certification reputed company 180 days of hire date as a condition of continuedemployment.Relevant Work Experience, Knowledge, Skills, and Abilities• 4 – 6+ years of relevant work experience, preferably with a healthcare provider (R)• 3 – 4+ years of clinical experience, including Medicaid experience. (R)• Additional experience/specialized training may be considered in lieu of educational requirements. (R)• Health plan experience, preferably in a clinical setting. (P)• Experience with Population Health Management. (R)• Experience with managing people/processes in care management settings. (R)• Strong organizing, prioritizing, and problem identification and solving skills. (R)• Analytical skills; attention to detail. (R)• Excellent communication skills (verbal, written, presentation, interpersonal) with reputed company types/levels of audiences. (R)• Proficient in MS Office (Word, reputed company, PowerPoint, Outlook, Teams, SharePoint, etc.). (R)• Proven track record of successfully completing projects/tasks in alignment with overall strategies. (R)Additional Information• Requisition ID: 1000001269• Hiring Range: $63,000-$110,000Pay DisclosureA good faith estimate of the compensation range for individuals hired to work for the reputed company Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case's facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.EEOC StatementWe are committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy or reputed company condition, marital status, national reputed company, disability, protected veteran status or any other characteristic protected by law.Sponsorship StatementDepending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, reputed company may provide work reputed company sponsorship for certain positions.Expected salary: $63000 - 110000 per yearLocation: reputed company, NYJob date: Sun, 03 Sep 2023 05:08:22 GMTApply for the job now! Apply tot his job Apply To this Job