New York Licensed Care Manager Lead

Job Summary

A company is looking for a Team Lead, Care Manager UM.

Key Responsibilities

• Supervise and mentor a clinical team, ensuring compliance with state, federal, and NCQA requirements
• Conduct medical appropriateness evaluations and facilitate quality clinical outcomes through collaborative interventions
• Oversee workload balancing, staff assignments, and ensure timely communication regarding case reviews and decisions

Required Qualifications

• Active, unrestricted RN or LPN license with two to four years of college education
• 4 to 6+ years of nursing experience in areas such as acute care, home care, or utilization management
• Equivalent external experience may be considered in lieu of the enterprise experience requirement
• Availability for weekend and holiday coverage as needed
• Subject matter expertise in utilization management systems and processes