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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 for their assigned caseload.
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 individual’s 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 public benefits necessary for healthcare services.
- Communicate and share information effectively 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 appropriate referrals, access, engagement, follow-up, and coordination of services.
- Engage in discharge planning for hospital admissions, ensuring 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)
- Knowledge of best practices working with children and families in health, preventive, and wellness care.
- Relevant expertise and experience in serving children and families in child welfare, developmental disabilities, mental health, healthcare, and/or other systems, as well as those receiving preventive services.
- Demonstrated knowledge and understanding of the needs of children and their families for high acuity enrollees (evidenced by additional years of experience, education, or training).
- Extensive experience in coordinating care for children with medical fragility.
- 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 for professional growth and/or improvement.
- 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.
- 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.
- Must have a valid Driver’s License and a clean driving record.
- Regularly required to stand; walk, use hands and fingers, handle, or feel objects; reach with hands and arms; talk and listen, and taste or smell.
- Frequently required to walk.
- Occasionally required to keep balance and stoop, kneel, crouch, or crawl.
- 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
- Care Management
- Needs Assessments (CANS)
- Individualized Plan of Care
- Service Coordination
- Medicaid Analytics Performance Portal (MAPP)
- Electronic Health Records (EHRs)
- Advocacy
- Wellness and Prevention
- Public Benefits Assistance
- Interdisciplinary Team Collaboration
- Community Resource Identification
- Referral Management
- Discharge Planning
- Staff Development
- Medicaid EPSDT Guidelines
- Computer Proficiency
- Office Equipment Operation
- English Fluency (Speaking, Reading, Writing)
- Valid Driver's License
- Clean Driving Record
- Accountability
- Writing
- Communication
- Organizational Skills
- Compassion
- Travel
- Feedback Reception
- Decisiveness
- Motivation
- Developmental Skills
- Management Skills
- Meeting Deadlines
- Compliance
- Record Maintenance
Location
- Irvington, 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
- Licensed Practical Nurse
Salary/Compensations
- $41567.00 - $50818.00