[Hiring] RN CARE MANAGER - COMPLEX CARE & HIGH UTILIZER MANAGEMENT @C2Q Health Solutions

Role Description

The RN Care Manager – Complex Care & High Utilizer Management is responsible for the comprehensive management of participants who exhibit high utilization of outpatient services, are at high risk for readmission, hospitalization, or ED visits, or present with complex behavioral health needs and chronic conditions such as COPD, Heart Failure, and Diabetes.

This role provides advanced clinical oversight, risk stratification, and proactive outreach to ensure participants receive timely, coordinated, and appropriate care. The RN Care Manager collaborates closely with medical providers, behavioral health specialists, and operational leaders to develop and implement strategies that reduce avoidable utilization, strengthen chronic disease management, and enhance participant experience.

The RN Care Manager also ensures that referrals—particularly those related to high-risk and complex participants—are clinically appropriate, timely, and aligned with evidence-based interventions for chronic disease care pathways.

Qualifications

• BSN required
• Current Registered Nurse (RN) license in New York State
• Certification in Case Management (CCM) or equivalent, preferred
• 3+ years of clinical experience in chronic disease management, care coordination, or case management
• Experience working with high-risk, medically complex, or high-utilizing populations
• Strong assessment, communication, and interdisciplinary collaboration skills
• Experience in PACE, MLTC, Managed Care, or high-risk care management preferred
• Prior experience with behavioral health integration or complex psychosocial case management preferred

Requirements

• Standing – Duration of up to 6 hours a day.
• Sitting/Stationary Positions – Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods.
• Lifting/Push/Pull – Up to 50 pounds of equipment, baggage, supplies, and other items used in the scope of the job using OSHA guidelines.
• Bending/Squatting – Must be able to safely bend or squat to perform essential functions.
• Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas.
• Agility/Fine Motor Skills – Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools.
• Sight/Visual Requirements – Must be able to visually read documentation, papers, orders, signs, etc., and type/write documentation with accuracy.
• Audio Hearing and Motor Skills – Must be able to listen attentively and document information accurately.
• Cognitive Ability – Must demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis.

Benefits

• Salary Range: $100,000.00 - $115,000.00
• Remote option only applicable in NY.
• Weekly Hours: 40

Disclaimer

Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.

We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.