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About the Role

Care Management is a service model where all of an individual’s caregivers communicate and interface to ensure the member’s needs are addressed comprehensively. A Care Manager oversees and provides access to all necessary services to prevent hospitalizations, maintain health, and ensure stability for their assigned caseload.

Responsibilities

• Obtain required Care Management enrollment consents from the individual or legal guardian.
• Complete initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the individual’s most appropriate level of care management.
• Manage the patient’s Individualized Plan of Care.
• Coordinate the enrollee’s provision of services as per their acuity level.
• Support adherence to treatment recommendations.
• Monitor and evaluate a patient’s needs, including prevention, wellness, medical, mental health, care transitions, and social and community services.
• Meet client contact requirements, including face-to-face visits on a consistent schedule for children.
• Meet Care Management documentation requirements in a timely and accurate manner utilizing the Care Management Portal (Medicaid Analytics Performance Portal; MAPP) and Electronic Health Records (EHRs).
• Act as an advocate for clients within the agency and with external service providers.
• Promote wellness and prevention by linking enrollees with resources and services.
• Educate the child/caregiver on care of chronic conditions, immunization, screening, and other preventative interventions.
• Help clients obtain and maintain public benefits necessary for healthcare services.
• Communicate and share information with the individual, families, and other caregivers, considering language, literacy, and cultural preferences.
• Conduct care planning meetings/conferences and serve as an interdisciplinary team member.
• Identify available community-based resources and manage referrals, access, engagement, follow-up, and coordination of services.
• Engage in the discharge planning process for hospitalized patients to ensure post-discharge services are in place.
• Attend and participate in ongoing staff development trainings.
• Ensure children have periodic evaluations and follow-up treatment for dental, vision, and hearing care, following Medicaid EPSDT guidelines.
• Perform other duties as needed by the Care Management Agency.

Requirements

• Must be able to use a computer and learn software programs.
• Must be able to operate a fax, copier, scan, and other office equipment.
• Must be able to speak, read, and write fluently in the English language.
• Must be able to write in the English language using correct spelling, grammar, and punctuation.
• Must have a valid Driver’s License and a clean driving record.
• May frequently lift 0-25 lbs., occasionally lift 25-50 lbs., and rarely lift over 50 lbs.
• May frequently push/pull 0-25 lbs. of force, occasionally push/pull 26-45 lbs. force, and rarely push/pull over 45 lbs.
• Will be required to sit, stand, and walk throughout the work day.
• May occasionally stoop.
• May occasionally kneel.
• May occasionally crouch.
• Relevant expertise and experience in serving children and families in child welfare, developmental disabilities, mental health, healthcare, and/or other systems, as well as those receiving preventive services.
• Care Managers serving high acuity enrollees must have demonstrated knowledge and understanding of the needs of such children and their families.
• Care Managers assigned to children who have medical fragility must have extensive experience in coordinating their care.
• Experience providing service coordination and information, linkages, and referrals for community-based services.
• Excellent accountability, writing, communication, and organizational skills.
• Compassion for servicing children and families with special needs.
• Ability to travel to community-based agency offices, participant’s communities, and homes within assigned catchment area.
• Ability to receive feedback to professionally grow and/or improve.
• Proven decisiveness, motivational, and developmental skills.
• Management abilities, including meeting deadlines, ensuring compliance with agency policies and procedures, and overseeing complete and timely maintenance of agency records.

Skills

• Care Management
• Needs Assessment
• Individualized Plan of Care
• Service Coordination
• Documentation
• Advocacy
• Wellness Promotion
• Community Resource Referral
• Discharge Planning
• Staff Development
• Medicaid EPSDT Guidelines
• Computer Proficiency
• Office Equipment Operation
• English Fluency
• Writing
• Driving
• Interpersonal Communication
• Organizational Skills
• Accountability
• Decisiveness
• Motivational Skills
• Developmental Skills
• Management Skills

Location

• New Windsor, NY 12553

Work Type

• Full-Time

Experience Level

• Two years of experience (with Associate Degree)
• Two years of experience (with Bachelor's Degree)
• Two years of experience (with RN or LPN license)
• Additional years of experience, education or training (for high acuity enrollees)
• Extensive experience (for medically fragile children)

Education Level

• Associate Degree
• Bachelor of Arts or Science
• Registered Nurse or Licensed Practical Nurse
• Master’s Degree in related field (Licensed preferred)

Salary/Compensations

• $41,567.00 - $50,818.00 Salary/year