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About the Role
Care Management is a service model where all of an individual’s caregivers communicate and interface to ensure the member’s needs are addressed comprehensively. A Care Manager oversees and provides access to all necessary services to prevent hospitalizations, maintain health, and ensure stability. The Care Manager is responsible for the overall provision and coordination of services to an assigned caseload, guiding program enrollees and their caretakers through the healthcare system.
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 most appropriate level of care management.
- Manage the patient’s Individualized Plan of Care.
- Coordinate the enrollee’s provision of services as per their acuity level.
- 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 contact requirements, including face-to-face visits on a consistent schedule for children.
- Meet Care Management documentation requirements in a timely and accurate manner utilizing the designated Care Management Portal (Medicaid Analytics Performance Portal; MAPP) 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.
- Educate the child/caregiver on care of chronic conditions, immunization, screening, and other preventative interventions.
- Assist clients in obtaining and maintaining necessary public benefits for healthcare services.
- Communicate and share information with the individual, families, and other caregivers, considering language, literacy, and cultural preferences.
- Conduct care planning meetings/conferences and serve as an interdisciplinary team member.
- Identify available community-based resources and manage referrals, access, engagement, follow-up, and coordination of services.
- Engage in the discharge planning process for hospital admissions, ensuring all recommended post-discharge services are in place.
- Attend and participate in ongoing staff development trainings.
- Ensure children have periodic evaluations and follow-up treatment for dental, vision, and hearing care, following Medicaid EPSDT guidelines.
- Perform other duties as needed by the Care Management Agency.
Requirements
- Associate Degree with two years’ experience
- Bachelors of Arts or Science with two years’ experience
- Registered Nurse or Licensed Practical Nurse with two years’ experience
- Master’s Degree in a related field (Licensed preferred)
- LMSW with 1 year experience
- Must have a valid Driver’s License and a clean driving record.
- Must be able to use a computer and learn software programs.
- Must be able to operate a fax, copier, scan, and other office equipment.
- Must be able to speak, read, and write fluently in the English language.
- Must be able to write in the English language using correct spelling, grammar, punctuation, etc.
- Relevant expertise and experience in serving children and families in child welfare, developmental disabilities, mental health, healthcare, and/or other systems.
- Experience providing service coordination and information, linkages, and referrals for community-based services.
- Excellent accountability, writing, communication, and organizational skills.
- Compassion for servicing 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 decisiveness, motivational, and developmental skills.
- Management abilities, including meeting deadlines, ensuring compliance with agency policies and procedures, and overseeing complete and timely maintenance of agency records.
Skills
- Care Management
- Needs Assessments (CANS)
- Individualized Plan of Care development
- Service coordination
- Documentation
- Advocacy
- Wellness and prevention
- Public benefits assistance
- Interdisciplinary team collaboration
- Referral management
- Discharge planning
- Staff development
- Medicaid EPSDT guidelines
- Computer proficiency
- Office equipment operation
- English fluency (written and verbal)
- Driving
- Bilingual (a plus)
Location
- Grand Concourse - Bronx, NY
Work Type
- Full Time
Experience Level
- 2 years experience (with Associate's or Bachelor's)
- 1 year experience (with Master's)
- 1 year experience (with LMSW)
Education Level
- Associate Degree
- Bachelor's degree
- Master's Degree
- Registered Nurse
- Licensed Practical Nurse
- LMSW
Salary/Compensations
- $41567.00 - $50818.00