New York Licensed Clinical Evaluation Manager

Job Summary

A company is looking for a Clinical Evaluation Manager (Remote).

Key Responsibilities

• Conducts comprehensive reviews of service requests, ensuring medical necessity and compliance with regulations
• Coordinates care management and develops patient-focused plans to facilitate safe transitions back into the community
• Maintains accurate records and provides input for improving department processes and procedures

Required Qualifications

• Current license to practice as a Registered Professional Nurse or Occupational Therapist in New York State
• Associate's Degree in Nursing or a Master's Degree in Occupational Therapy required; Bachelor's or Master's Degree in Nursing preferred
• Minimum two years of experience in case management or acute inpatient hospital settings
• Knowledge of Medicare and Medicaid regulations required
• Experience working with the LTSS eligible population preferred