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About the Role
The Health Home Care Manager is responsible for coordinating comprehensive services and supports for individuals enrolled in the New York State Health Home program. The Care Manager works directly with individuals, families, healthcare providers, behavioral health providers, social service agencies, and community organizations to ensure that members receive coordinated, person-centered care.
Responsibilities
- Complete comprehensive assessments and identify the individual's medical, behavioral health, social, and functional needs.
- Develop, implement, and regularly update an individualized Plan of Care in collaboration with the member and care team.
- Build trusting relationships with individuals and support them in identifying and achieving personal goals.
- Coordinate medical, behavioral health, substance use, dental, developmental, social service, and community-based services.
- Assist individuals in establishing and maintaining relationships with primary care providers, specialists, mental health providers, substance use providers, dentists, and other service providers.
- Advocate for individuals and help them navigate complex healthcare and social service systems.
- Identify barriers to care and assist individuals in developing solutions to overcome those barriers.
- Connect individuals with community resources related to housing, food, transportation, employment, benefits, education, financial assistance, and other social determinants of health.
- Monitor appointments, referrals, treatment recommendations, and follow-up needs.
- Communicate and collaborate with healthcare providers and other members of the individual's care team.
- Participate in care team meetings and coordinate communication among providers.
- Provide health education and support individuals in developing skills to manage their health and wellness.
- Assist individuals with transitions of care following hospitalizations, emergency room visits, rehabilitation stays, or other significant changes in care.
- Complete required documentation, assessments, care plans, progress notes, and other program documentation in a timely and accurate manner.
- Maintain compliance with New York State Health Home requirements, agency policies, procedures, and applicable regulations.
- Maintain confidentiality and protect member information in accordance with HIPAA and applicable laws and regulations.
- Maintain regular contact with assigned members in accordance with program requirements and individual needs.
- Transport or accompany individuals to appointments and community resources when appropriate and permitted by agency policy.
- Participate in staff meetings, training, supervision, quality improvement activities, and other agency activities.
- Other duties as assigned.
Requirements
- Valid driver's license and reliable transportation.
- Ability to successfully complete required background checks and clearances.
- Strong communication, organizational, documentation, and time-management skills.
- Ability to work independently while also functioning effectively as part of a multidisciplinary team.
- Ability to maintain professional boundaries and confidentiality.
- Compassionate, respectful, and person-centered approach to working with individuals.
- Experience in care management, case management, healthcare, behavioral health, substance use services, developmental disabilities, social services, or a related field.
- Experience working with individuals who have complex medical, behavioral health, or social needs.
- Knowledge of New York State Health Home services and community resources.
- Experience working with electronic health records and/or care management documentation systems.
Skills
- Communication skills
- Organizational skills
- Documentation skills
- Time-management skills
- Ability to work independently
- Ability to function effectively as part of a multidisciplinary team
- Ability to maintain professional boundaries
- Ability to maintain confidentiality
- Compassionate approach
- Respectful approach
- Person-centered approach
- Care management
- Case management
- Healthcare
- Behavioral health
- Substance use services
- Developmental disabilities
- Social services
- Working with individuals who have complex medical needs
- Working with individuals who have complex behavioral health needs
- Working with individuals who have complex social needs
- Knowledge of New York State Health Home services
- Knowledge of community resources
- Electronic health records
- Care management documentation systems
Location
- Franklin County
Work Type
- Full-time
Experience Level
- Experience in care management, case management, healthcare, behavioral health, substance use services, developmental disabilities, social services, or a related field.
- Experience working with individuals who have complex medical, behavioral health, or social needs.
Education Level
- Associate's or Bachelor's degree in social work, human services, psychology, healthcare, public health, behavioral health, or a related field.
Benefits
- Competitive salary
- Health insurance
- Dental and vision insurance
- Paid time off
- Paid holidays
- Retirement plan
- Employee assistance/support resources
- Professional development and training opportunities
- Opportunities for advancement
About the Company
- Community Connections of Franklin County is an Equal Opportunity Employer. We are committed to providing an inclusive workplace and do not discriminate against applicants or employees on the basis of any legally protected characteristic.
Equal Opportunity
- Community Connections of Franklin County is an Equal Opportunity Employer. We are committed to providing an inclusive workplace and do not discriminate against applicants or employees on the basis of any legally protected characteristic.