NEW JOB OPENING
BILINGUAL RN CASE MANAGER (ENGLISH & SPANISH)
IN Remote, USA!

Required Education

• Associate degree in Nursing



Preferred Education

• Bachelor's degree in Nursing (BSN)



Required License/Certification

• Active, unrestricted Registered Nurse (RN) license in the state of New York



Preferred License/Certification

• Certified Case Manager (CCM)



Required Qualifications/Skills/Experience

• Minimum of 3 years of case management experience in a hospital, home health, or ambulatory care setting

• Must be fluent in English/Spanish (Writing, Reading, Speaking)

• Strong clinical assessment and critical-thinking skills

• Experience coordinating care across multidisciplinary teams

• Ability to develop and implement individualized care plans

• Proficiency with electronic health record (EHR) documentation

• Strong organizational and time management skills



Preferred Qualifications/Skills/Experience

• Experience with discharge planning

• Background in managed care

• Experience working with Managed Long-Term Services and Supports (MLTSS)

• Crisis intervention experience



Bilingual RN Case Manager English & Spanish Overview

The Case Manager utilizes a collaborative approach to assess, plan, coordinate, facilitate, and advocate for healthcare services that meet members' clinical needs while maximizing available benefits and resources. This role is responsible for conducting comprehensive telephonic assessments for members enrolled in Managed Long-Term Services and Supports (MLTSS) and in-person assessments for non-MLTSS members to determine medical necessity and appropriate service referrals. The Case Manager collaborates with members, caregivers, providers, and interdisciplinary care teams to develop individualized care plans, coordinate services, support safe transitions of care, and promote quality, cost-effective outcomes. Success in this role requires strong clinical judgment, effective communication, thorough documentation, and the ability to manage diverse adult and pediatric populations with varying levels of medical complexity.



Job Duties

• Conduct comprehensive telephonic assessments for members enrolled in MLTSS using standardized assessment tools

• Perform in-person assessments for non-MLTSS members to evaluate medical needs and determine appropriate services

• Coordinate referrals for adult medical daycare, pediatric medical daycare, personal care assistant services, nursing facility custodial care, Personal Preference Program, and MLTSS enrollment

• Assess and manage the needs of pediatric and medically complex members

• Collaborate with members, authorized representatives, primary care providers, and interdisciplinary care teams

• Schedule, coordinate, and participate in interdisciplinary care meetings

• Advocate for members to ensure safe transitions of care and appropriate service delivery

• Develop individualized care plans based on member assessments and clinical needs

• Authorize services within MLTSS/FIDE program benefits while promoting cost-effective care

• Maintain accurate, timely, and complete documentation in the electronic health record

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**