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About the Role

The Care Manager partners with individuals with I/DD, their families/guardians, and providers to coordinate care and services. This role assists individuals in achieving optimal health, wellness, independence, community integration, and accomplishing goals. The Care Manager provides Health Home core services including comprehensive care management, care coordination, health promotion, transitional care, individual and family support, referrals to community and social support services, and utilizes Health Information Technology to link services, all with a person-centered approach.

Responsibilities

• Conduct comprehensive assessments to identify an individual’s clinical and psychosocial needs, choices, and preferences for services.
• Assess and address health and safety issues, barriers to care and treatment, and social determinants of health.
• Collaborate with interdisciplinary teams and incorporate input into comprehensive assessments and the individual’s Life Plan.
• Facilitate, develop, and maintain a person-centered Life Plan integrating personal wants and needs, clinical and non-clinical healthcare needs, community services, OPWDD services, and natural supports.
• Incorporate health promotion and support opportunities for individuals to achieve and maintain optimal health and wellbeing.
• Adhere to Incident Management regulations, guidelines, and policies and procedures.
• Coordinate and ensure access to chronic disease management.
• Facilitate referrals to clinical and community resources, including planning, implementation, and follow-up for comprehensive care management and transitional care.
• Participate in internal and external audits.
• Coordinate and provide access to long-term care supports and services.
• Engage families and natural supports in the care coordination process.
• Provide culturally and linguistically appropriate services to all individuals and families.
• Advocate on behalf of the individual.
• Promote self-advocacy and the ability to self-direct.
• Use Health Information Technology for documentation, to link services, and facilitate communication among the care coordination team.
• Secure all health records and other protected information with the highest regard to confidentiality and HIPAA laws and regulations.
• Maintain compliance with all state and federal laws and regulations, Medicaid compliance, and PCC policies and procedures.
• Document all services and maintain appropriate records following all established documentation policies and procedures.
• Complete all required training, including annual, ongoing, and educational trainings.
• Perform all other duties relevant to the position as requested.

Requirements

• Ability to act quickly, assess and act accordingly in crisis situations.
• Intermediate technology skills in Outlook, Teams, Word, Excel, and online applications as needed.
• Understanding of EHR system usage.
• Knowledge of ethical and professional responsibilities and boundaries.
• Demonstrate professional work habits including dependability, time management, organization, autonomy, and productivity.
• Ability to sit/stand throughout the day to accomplish job.
• Ability to enter data, notes, and other documentation into a computer.
• Must be able to travel throughout covered territories in Upstate NY as needed.
• Must have a valid driver’s license.
• Ability to conduct in-person visits and meetings at individuals' homes, communities, schools, and other locations as applicable.
• Adhere to all Prime Care Coordination policies and procedures.
• Adhere to the Agency Mission, Vision, Shared Values, and Customer Service Standards.
• Attend mandatory education and training modules as scheduled; obtain and maintain required certifications.
• Maintain all required certifications/training by State regulations and PCC policy.
• Act as a professional representative of PCC in regard to appearance, behavior, temperament, communication, language, and dress.

Skills

• Bi-lingual skills (some positions may require)

Location

• Upstate NY
• Remote
• Satellite office locations
• Primary office location

Work Type

• Full-time

Experience Level

• Two years of relevant experience with a Bachelor's degree
• Two years of relevant experience with a Registered Nurse license
• One year of relevant experience with a Master's degree

Education Level

• Bachelor's degree
• Registered Nurse license
• Master's degree

Benefits

• Paid time off (25 days per year)
• 10 Paid Holidays
• Affordable health care coverage including health, dental, vision, starting as low as $10.00/month
• 401(K) Retirement plan
• Tuition Reimbursement
• Generous Employee referral program
• Employee Wellness Program (earn up to $250 per year!)
• Numerous other benefits

About the Company

• Prime Care Coordination is committed to equal employment opportunity.

Equal Opportunity

• We recruit, employ, train, compensate, and promote without regard to race, religion, color, national origin, age, sex, disability, protected veteran status, or any other basis protected by applicable federal, state, or local law.
• Prime Care Coordination will make reasonable accommodations for known physical or mental limitations of otherwise qualified employees and applicants with disabilities unless the accommodation would impose an undue hardship on the operation of our business.
• If you are interested in applying for an employment opportunity and feel you need a reasonable accommodation pursuant to the ADA, please contact us at 585-347-1037.