Job type full-time
Full job description
The care manager plans and manages behavioral and/or physical care with under 21 members and their parents/legal guardians and providers to achieve better health outcomesThe care manager facilitates and coordinates behavioral and physical health care to address identified members’ needs across the continuum of careThe cm adheres to clinical standards of care for the under 21-member population including but not limited to sed, developmentally disabled, medically fragile, and foster care populations, through collaboration with guardians, providers and other internal and external partnersThe cm will also adhere to departmental and state guidelines for hcbs and state plan services and monitor for appropriate outcomes.
Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.
Conducts assessments to identify barriers and opportunities for intervention.
Develops care plans that align with the physician’s treatment plans and recommends interventions that align with proposed goals.
Generates referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement.
Collaborates with provider doctors, social workers, discharge planners, and community-based service providers to coordinate care accordingly.
Coordinates and facilitates care with hospitals, multi-disciplinary health care teams as necessary to ensure care plan goals are achieved and maximize member outcomes.
Assists in identifying opportunities for alternative care options based on member needs and assessments.
Evaluates service authorizations to ensure alignment and execution of the member’s care and physician treatment plan.
Contributes to corporate goals through ongoing execution of member care plans and member goal achievement.
Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate.
Occasional overtime as necessary.
Additional duties as assigned.
Nys rn or
Lcsw, lmsw, lmft, lmhc, lpc, licensed psychologist
Nys licensure is required for all licenses
Working knowledge of city and state agencies and practices to include ocfs, omh, cse, vfca, acs,
Experience with aot, act, and health home,
Experience working sed, developmentally disabled, medically fragile and foster care populations
Experience working with low-income populations
Experience working with youth with dual diagnosis of mental health and substance abuse
Case management experience
Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, along with demonstrated ability to handle rapidly changing crisis situations.
Fluency in spanish, korean, mandarin, or cantonese.
Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors.
Knowledge of interqual and locadtr.
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 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
Please note: since we care so greatly about our employees` and members` wellbeing, healthfirst is moving to an environment where our employees are fully vaccinated against covid-19As a prospective new team member, you must be fully vaccinated with a cdc/fda approved covid-19 shot(s) to work in our officesIf you are selected to interview for this role, we will explain our vaccination policy in further detail and ensure you are comfortable moving forward with this company policy.
We are an equal opportunity employerApplicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected federal, state/province or local status unrelated to the performance of the work involved.
If you have a disability under the americans with disability act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798In your email please include a description of the accommodation you are requesting and a description of the position for which you are applyingOnly reasonable accommodation requests related to applying for a position within healthfirst management services will be reviewed at the e-mail address and phone number suppliedThank you for considering a career with healthfirst management services.
Eeo law poster and supplement
All hiring and recruitment at healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our companyAny recruitment firm representing healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring aboutIf you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by healthfirstHealthfirst will never ask you for money during the recruitment or onboarding process.
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