New York Licensed Pediatric Care Manager

Job Summary

A company is looking for a Pediatric Care Manager, Complex & Disease Management (Remote).

Key Responsibilities

• Provide care management and coordination for high-risk members, including assessments and identifying gaps in care
• Develop and implement medical management strategies and interventions in collaboration with members, caregivers, and healthcare providers
• Advocate for members by facilitating interventions with providers and community resources, ensuring compliance with regulations and standards

Required Qualifications

• Bachelor's degree required
• Current active RN license required; CCM certification preferred
• 4 - 6 years of clinical experience required
• Experience in case management, care coordination, or utilization management
• Ability to manage a caseload of highly complex members effectively