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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 enrollees and their caretakers through the healthcare system by assisting with access issues, developing provider relationships, and tracking interventions and outcomes.
Responsibilities
- Obtains required Care Management enrollment consents from the individual or legal guardian.
- Completes initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the individual’s most appropriate level of care management.
- Responsible for the overall management of the patient’s Individualized Plan of Care.
- Coordinates the enrollee’s provision of services as per their acuity level.
- Supports adherence to treatment recommendations.
- Monitors and evaluates a patient’s needs, including prevention, wellness, medical, mental health, care transitions, and social and community services.
- Meets client contact requirements, including face-to-face visits for children on a consistent schedule.
- Meets Care Management documentation requirements in a timely and accurate manner utilizing designated Care Management Portal (Medicaid Analytics Performance Portal; MAPP) and Electronic Health Records (EHRs).
- Functions as an advocate for clients within the agency and with external service providers.
- Promotes wellness and prevention by linking enrollees with resources and services.
- Educates the child/caregiver on care of chronic conditions, immunization, screening, and other preventative interventions.
- Helps clients obtain and maintain public benefits necessary for healthcare services.
- Effectively communicates and shares information with the individual, families, and other caregivers, considering language, literacy, and cultural preferences.
- Conducts care planning meetings/conferences and serves as an interdisciplinary team member.
- Identifies available community-based resources and manages referrals, access, engagement, follow-up, and coordination of services.
- Engages in the discharge planning process for hospital admissions, ensuring post-discharge services are in place.
- Attends and participates in ongoing staff development trainings.
- Ensures children have periodic evaluations and follow-up treatment for dental, vision, and hearing care, following Medicaid EPSDT guidelines.
- Performs other duties as needed by the Care Management Agency.
Requirements
- 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, and punctuation.
- May frequently lift 0-25 lbs., occasionally lift 25-50 lbs., and rarely lift over 50 lbs.
- May frequently push/pull 0-25 lbs. of force, occasionally push/pull 26-45 lbs. force, and rarely push/pull over 45 lbs.
- Will be required to sit, stand, and walk throughout the work day.
- May occasionally stoop.
- May occasionally kneel.
- May occasionally crouch.
Skills
- Excellent accountability skills
- Excellent writing skills
- Excellent communication skills
- Excellent 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 assigned catchment area
- Ability to receive feedback to professionally grow and/or improve
- Proven decisiveness skills
- Proven motivational skills
- Proven developmental skills
- Management abilities, including meeting deadlines, ensuring compliance with agency policies and procedures, and overseeing complete and timely maintenance of agency records
Location
- New Windsor, NY
Work Type
- Full Time
Experience Level
- 2 years experience
- 1 year experience
Education Level
- Bachelor's degree
- Master's degree
- Associate Degree
- Registered Nurse or Licensed Practical Nurse
Salary/Compensations
- $41567.00 - $50818.00