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About the Role
The Health Home Children's Care Manager provides care coordination and support to clients with chronic medical and behavioral health conditions that are also impacted by social determinants of health. Assists clients to navigate social service, community, and healthcare systems.
Responsibilities
- Utilizes approved Children’s Health Home clinical tools and technology to prepare initial and ongoing clinical and psychosocial assessments of service needs of identified clients.
- Confirms acuity level of identified client and tailors care plan accordingly, reassessing as needed.
- Develops, coordinates and integrates a coordinated care plan in cooperation with the client, the client’s family, and/or the other providers serving the patient.
- Updates plan at specified intervals, and as needed based on changes in client’s condition / circumstances.
- Participate in integrated care efforts with all providers known to the client to monitor the treatment plan and treatment progress.
- Performs and maintains effective care management for a caseload of clients, as assigned, from assessment to discharge.
- Tracks/ monitors client progress and produces/maintains detailed, accurate and timely case notes.
- Facilitates periodic case record reviews and case conferences with all providers serving the patient.
- Reviews new cases for completeness of documentation.
- Provides linkage, coordination with, referral to and follow-up with appropriate ongoing service providers.
- Attends planning meetings with service providers to coordinate service plans.
- Works effectively with interdisciplinary team of providers including PCP, substance abuse treatment, residential, hospital discharge planners, etc., to coordinate care delivery between all linked providers and client.
- Maintains updated case records through health home EMR, and coordinates effective electronic communication throughout all provider databases, as needed.
- Maintains case records in accordance with health home policies/procedures, agency standards and regulatory requirements.
- Engages the client’s school through interaction with school social workers and other officials to act as the client’s academic health advocate.
- Report any suspected child abuse to the appropriate bodies.
- Participates and consults with team supervisor in case conferences, staff meetings, and discharge planning meetings to determine if client requires an alternate level of care or is appropriate for discharge.
- Performs other duties and participates in special projects, as required.
Requirements
- Ability to communicate well with medical providers and support staff.
- Ability to work well with diverse population.
- Prior work with children required.
- Ability to handle multiple tasks and stressful environment.
- Ability to work well within the organizational structure.
- Ability to work flexible hours including some evenings and weekends.
Location
- Manhattan, New York
Work Type
- Full-time
Education Level
- Bachelor’s degree with 2 years of related work experience required
- Masters degree preferred
Salary/Compensations
- $29.00 - $33.03 per hour
About the Company
- Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who seek it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable.
- Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia and Westchester County.
- The mission of Sun River Health is to increase access to comprehensive primary and preventive health care and to improve the health status of our community, especially for the underserved and vulnerable.
Equal Opportunity
- Sun River Health provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, sexual preference, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.
- Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation.
- The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.