New York Licensed Care Manager Lead

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