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About the Role
Health Home Plus Care Managers provide comprehensive support to individuals to coordinate all health care needs, including medical, mental health, substance abuse, specialty care, and social services. Ongoing care management activities must demonstrate active progress toward achieving each member’s goals.
Responsibilities
- Engage directly with clients to stabilize housing and address medical/psychiatric needs.
- Connect clients to appropriate community services and resources.
- Provide intensive Health Home Care Management (HHCM) to adults with Serious Mental Illness (SMI) enrolled in the Health Home Plus (HH+) program.
- Ensure clients at high risk for chronic disease and early mortality receive enhanced care.
- Deliver a minimum of four (4) Health Home core services monthly—two (2) of which must be face-to-face.
- For individuals under AOT (Assisted Outpatient Treatment), conduct at least four (4) face-to-face visits monthly.
- Maintain required caseload ratios: one (1) full-time care manager per 20 HH+ recipients.
- Participate in regular supervision and follow guidelines as outlined by the Department of Health.
- Attend regular internal team meetings to review caseload progress and goal attainment.
- Accurately document services and outcomes to ensure compliance with billing and quality standards.
- Collaborate with interdisciplinary teams to align services with individual care plans.
- Utilize clinical discretion and best practices when supporting high-need individuals.
- Adhere to organizational protocols and contractual obligations under the HH+ program model.
Requirements
- Valid and unrestricted driver’s license
- Required to have a reliable vehicle to use during work day
- Must be willing to travel to multiple counties
- Ability to maintain a non-judgmental disposition and communication with a diverse population
- Comfortable with working independently and as part of a collaborative team.
- Must be capable of accessing all rooms in a 2-story home
- Able to work in open space floor plan
- Must be capable of moving throughout workday
- Occasional lifting of > 25+ pounds
Skills
- Excellent oral and written communication skills
- Effective verbal and written communication skills
- Proficient technology and computer skills including internet, email, word processing, spreadsheets, electronic health records, and databases.
- Ability to use technology to communicate effectively and professionally, and organize information
- Ability to engage and build rapport with high-risk individuals and vulnerable populations.
- Strong communication, time management, and organizational skills.
- Sensitive to cultural diversity and trauma-informed care principles.
- Demonstrated ability to link clients with a broad range of services (medical, psychiatric, legal, housing, etc.).
Location
- Nanuet, NY
Work Type
- Monday-Friday 8:30AM-5:00PM with Flexibility (40hrs)
Experience Level
- Two (2) years of related experience providing direct services to individuals with SMI, developmental disabilities, or substance abuse issues.
- A master’s degree in a relevant field may substitute for one (1) year of required experience.
Education Level
- Bachelor’s degree in social work, psychology, nursing, rehabilitation, education, occupational/physical therapy, recreation, counseling, community mental health, child/family studies, sociology, speech/hearing, or another human services field
- NYS teacher’s certificate requiring a bachelor’s degree
- NYS RN licensure with bachelor’s degree
- Bachelors in any field with five (5) years of direct experience with individuals with behavioral health diagnoses
- CASAC (Credentialed Alcoholism and Substance Abuse Counselor) certification.
Salary/Compensations
- $25.00 per hour
About the Company
- Do Work That Matters. In a Culture That Means It.
- Be part of a team that values connection, accountability, and real impact.
- At Access, our Culture Playbook isn’t a poster on the wall – it’s how we show up for each other and for the people we support.
- You’ll be part of a team that is: Clear about expectations, Supportive and accountable, Focused on outcomes that matter to people.
- Committed to helping people live the healthiest and fullest lives possible – while making sure out staff can do the same.
Equal Opportunity
- An Equal Opportunity Employer, including disability and Veterans