#hiring Healthcare - Care Manager III, New York City, United States, fulltime #jobs #jobseekers #careers #NewYorkCityjobs #NewYorkjobs #HealthcareMedical
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Job Title: Care Manager IIILocation: RemoteDuration: 6 Months Job Description: Will the position be 100% remote? There are some circumstances that CM need to visit mbr at home or in facilityBut the chance is extremely low.• Are there any specific location requirements? No- They can sit anywhere in US as long as they are licensed in NY State but they will not be able to convert to perm if they are not in tri state area.• What are the must have requirements? Knowledge of MLTC and NY Medicaid policyActually creating the care plans for adult/ geriatric patientsNot just working with MLTC dept coordinatorAlso NOT in just a hospital or nursing home or facility.• What specific experience do they need to have/know? MLTC experience, Acknowledge of UAS Assessment.• What are the day to day responsibilities? Outreach calls and Person-Centered Care Plan reviewsCoordinate care, manager caseload, create Patient Centered Service Plans.• Is there specific licensure is required in order to qualify for the role? RN/LMSW/LCSW- Licensed in the State of NY• What languages are required? Spanish• What sort of case load will this person manage? 2-3 PCSP review per day, or 225-230 caseloadFor context the NY Health plan added 940 new members last month.Must have previous experience working remoteSelf-motivated, tech savvy and able to work indecently to complete a min of 7 successful calls a day,At the end of the month the CM must have 125 contacts with members.Will require- laptop, keyboard, mouse, headset, dual monitors and a docking station.Summary: Responsible for health care management and coordination of members in order to achieve optimal clinical, financial and quality of life outcomesWorks with members to create and implement an integrated collaborative plan of careCoordinates and monitors Client members progress and services to ensure consistent cost effective care that complies with Client policy and all state and federal regulations and guidelinesEssential Functions:Provides case management services to members with chronic or complex conditions including: o Proactively identifies members that may qualify for potential case management serviceso Conducts assessment of member needs by collecting in-depth information from Clients information system, the member, members family/caregiver, hospital staff, physicians and other providerso Identifies, assesses and manages members per established criteriao Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needso Performs ongoing monitoring of the plan of care to evaluate effectivenesso Documents care plan progress in Clients information systemo