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About the Role

The Care Manager is responsible for the overall provision and coordination of services to an assigned caseload. This role guides program enrollees and their caretakers through the healthcare system by assisting with access issues, developing relationships with service providers, and tracking interventions and outcomes.

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.
• Develop and manage the patient’s Individualized Plan of Care.
• 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 monthly contact and billing requirements.
• Meet Care Management documentation requirements in a timely and accurate manner by utilizing the designated Care Management Portal 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 based on their individual needs and preferences.
• Educate the child/caregiver on care of chronic conditions, immunization, screening, and other preventive interventions.
• Help clients obtain and maintain public benefits necessary to gain healthcare services, including Medicaid and cash assistance eligibility, Social Security, SNAP, housing, legal services, employment and training supports, and others.
• Effectively communicate and share information with the individual, their families, and other caregivers, considering language, literacy, and cultural preferences.
• Conduct care planning meetings/conferences and serve as an interdisciplinary team member to provide/coordinate comprehensive and holistic care.
• 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, ensuring all recommended post-discharge services are in place prior to discharge.
• Attend and participate in ongoing staff development trainings to enhance skills.
• Ensure children have periodic evaluations and follow-up treatment for dental, vision, and hearing care, following Medicaid EPSDT guidelines.
• Perform other related duties as assigned by supervisor.

Requirements

• Bachelors of Arts or Science with two years’ experience.
• 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.
• Experience providing service coordination and information, linkages, and referrals for community-based services.
• Excellent writing, communication, and organizational skills.
• A passion for serving children and families with special needs.
• Ability to travel to community-based agency offices, participant’s communities, and homes within the assigned catchment area.
• Ability to receive feedback to professionally grow and/or improve.
• Proven self-management abilities, including meeting deadlines, ensuring compliance with agency policy and procedures, and overseeing complete and timely maintenance of agency records.
• Authorized to work in the U.S.
• Ability to work in-person in New York City (NYC).
• Ability to travel to other Rising Ground Sites (if required).
• Ability to travel in the community and do visits.

Skills

• Bilingual Spanish is a plus
• Excellent writing skills
• Excellent communication skills
• Excellent organizational skills
• Self-management abilities
• Meeting deadlines
• Ensuring compliance with agency policy and procedures
• Overseeing complete and timely maintenance of agency records

Location

• Manhattan
• The Bronx
• Brooklyn
• Queens
• New York City (NYC)

Work Type

• Full-time
• Field
• Corporate Office
• Clinic
• Travel required

Experience Level

• Two years’ experience

Education Level

• Bachelors of Arts or Science

Benefits

• 11 Paid Holidays
• Paid Sick Time
• Paid Vacation
• Paid Personal days
• Medical - 3 plan options
• Dental - 2 plan options
• Vision - 1 plan option