Evaluate members’ care needs and promote quality outcomes and treatment via a variety of modalities and engagement strategies
Work directly with members in field-based settings and telephonically to support members’ unique care needs and engagement with treatment providers
Collaborate with hospital clinicians and care management team members (RNs, Social Workers, MDs, Coordinators) to address member needs across the continuum of care
Provide education and consultation to members, family/caregivers, and other parties involved in the member’s care
Make community-based field visits, including on-site hospital/facility-based visits around downstate New York
Apply care management principles by advocating, informing, and educating beneficiaries on services, self-management techniques, and health benefits
Review discharge planning, assessments, medical records, and screening for members currently admitted to assigned facilities
Assess need for home care, out of home placement, and/or community-based services and perform Utilization Review as needed
Develop care plans aligned with the physician’s treatment plans and recommend interventions
Complete social determinant of health assessments to identify barriers and opportunities for intervention
Generate referrals to providers, community-based resources, and appropriate services to assist in goal achievement
Liaise between service providers (doctors, social workers, discharge planners, community providers) to ensure coordinated care
Coordinate and facilitate with the multidisciplinary health care team to ensure person-centered care plans
Discuss and execute discharge plans with hospital and HF leadership
Evaluate treatment alignment with the member’s care and physician treatment plan and identify alternative care options
Document all encounters in the appropriate system in accordance with internal documentation procedures and update care plans as appropriate
Occasional overtime and additional duties as assigned
For CASAC positions only: Credentialed Alcohol and Substance Abuse Counselor
Ability to travel around downstate New York which includes the 5 boroughs, Long Island, and Westchester
Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers
Demonstrated ability to handle rapidly changing crisis situations
Experience in hospital/facility discharge planning
Bilingual in Spanish, Korean, Mandarin, or Cantonese (preferred)
Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors
Experience managing member information in a shared network environment using paperless database modules and archival systems
Relevant work experience preferably as a Care Manager
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment
Proficient with simultaneously navigating the Internet and multi-tasking with multiple electronic documentation systems
Experience using Microsoft Excel with the ability to edit, search, sort/filter and other Microsoft and PHI systems
Occasional overtime as necessary
Benefits
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions
(all benefits are subject to eligibility requirements)
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementdischarge planningutilization reviewsocial determinant of health assessmentsmember information managementcrisis interventioncommunity health practicescase management
Soft skills
interpersonal skillsassessment skillscommunication skillsability to relate to seniorsability to handle crisis situationsmultitaskingorganizational skills
Certifications
LCSWLMSWLMFTLMHCLPClicensed psychologistCredentialed Alcohol and Substance Abuse Counselor