Salary
💰 $81,099 - $116,480 per year
About the role
- Provide telephonic and occasional onsite care management to high-risk, medically frail members
- Engage members, their supports, providers, and health care team members to coordinate care and improve outcomes
- Attend Interdisciplinary Team (IDT) rounds several times per week to discuss high-risk cases
- Conduct assessments to identify barriers and opportunities for intervention and develop care plans aligned with physician treatment plans
- Conduct home visits and field visits to members and local healthcare facilities as needed
- Generate referrals to providers, community-based resources, and appropriate services
- Liaise between service providers (doctors, NPs, social workers, discharge planners, community providers) to ensure coordinated care
- Coordinate and facilitate multi-disciplinary health care team to ensure person-centered treatment and goal achievement
- Evaluate service authorizations for alignment with member care and physician treatment plans
- Document all encounters in appropriate systems and update care plans accordingly
- Contribute to corporate goals through execution of member care plans and member goal achievement
Requirements
- NYS RN, or LCSW, LMSW, or licensed psychologist (any state)
- Ability to travel around downstate New York including the 5 boroughs, Long Island, and Westchester
- Fluency in Spanish, Korean, Mandarin, or Cantonese (preferred; title indicates bilingual Spanish)
- Strong interpersonal and assessment skills, especially relating to seniors and community care providers
- Knowledge and experience with community health practices for frail adult population and cognitively impaired seniors
- Experience managing member information in a shared network environment using paperless database modules and archival systems
- Experience and knowledge of the relevant product line
- Relevant work experience preferably as a Care Manager
- Demonstrated ability to manage member panels and work effectively in a fast-paced environment
- Proficient with simultaneously navigating the Internet and multi-tasking with multiple electronic documentation systems
- High level of competency using Microsoft Excel, Word and PowerPoint, including ability to manage large data sets and reports
- M-F, 8:30am-5pm availability; occasional overtime as necessary
- Ability to conduct 3-5 field visits per month and at least 1 field visit per week (hybrid/field-based requirement)