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Care Manager, HIV/AIDs Plan
Ref No.: 17-00893
Location: Brooklyn, New York
Title: Care Manager, HIV/AIDS Plan
Location: Brooklyn, NY
Duration: RTH or Direct hire

Responsibilities and Qualifications:
Improves clinical and cost-effective outcomes by reducing hospital admission and emergency department visits for members enrolled in Medicare and Medicaid, through on-going member education, care coordination and collaboration with providers of care. Provides telephonic case management to members, balancing clinical, social, and environmental concerns. Ensures services provided are in compliance with Medicare and Medicaid policies and procedures, as well as applicable state and federal regulations. Works under general supervision.

Licensure: License and current registration to practice as a registered professional nurse in New York State required. Certified Case Manager Certification preferred.

Education: Bachelor's or Master's Degree in Nursing preferred.

Experience: Minimum of two years of experience in a managed care organization or health plan, preferably in utilization review with cost containment/case management, required. Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills required. Working knowledge of Microsoft Excel, Power-Point, and Word required. Knowledge of Medicare/Medicaid and/or commercial regulations required. Knowledge of Milliman criteria (MCG) preferred. Bilingual skills preferred.