Care Manager

Care Manager Immediate Hire (Bronx, Brooklyn, Manhattan, Queens)

Care Management is a service model whereby all an individual's caregivers communicate and interface so that the patient's needs are addressed in a comprehensive manner. This is done primarily through a "Care Manager" who oversees and provides access to all the services an individual’s needs to ensure that they receive everything necessary to prevent hospitalizations, stay healthy, and maintain stability.

• Provide daily oversight of an assigned panel of high-need candidates/members, delivering interventions designed to reduce unnecessary emergency department (ED)/emergency room (ER) and inpatient (IP) utilization, increase connection to primary care/behavioral health care, and demonstrate improved health outcomes for the served population. Communicate changes in member’s status (e.g., mental health, medical, social determinants impacting health and wellness) to the care team
• Administer program requirements as defined by all applicable federal, state, local, and agency guidelines (e.g., assessments, care plans, documentation of services, etc.) and other Health Home documentation required to address member needs.
• Monitor alerts (e.g., hospital admission/discharge, incarceration, ER/ED visit, etc.) and provide onsite follow up with members promptly, verifying appropriate levels of care and access to all needed medications, therapies, and supports in managing care transitions.
• Provide regular, field based face-to-face visits with members/candidates and providers in home and /or community settings, ensuring core services and HML are completed monthly.
• Participate in case conferences as needed to ensure that each member’s care team is aligned with a shared plan of care and up-to-date information on each member. Provide written status updates on a regular basis as requested (case conference tool, emails, etc.) and verify documentation of all such activities in member chart.
• Adhere to timeframes and quality standards regarding completion of member assessments, reassessments, care plans, progress notes and documentation standards.
• Manage schedule to allow for adequate field time, travel time, and time to complete administrative duties of position. Maintain communication with supervisor on changes in schedule.
• Maintain positive partnerships with providers and clinics
• Maintain a directory of provider services including medical, behavioral health, social support, and other services as needed to support referral and coordination activities of assigned members. Identify valuable resources to share with the rest of the team to the benefit of all members.
• Maintain positive and productive personal presentation within and outside of the assigned hub/office(s), ensuring all engagements with leadership, staff/coworkers, members, and community partners are professional, courteous, and respectful.
• Develop and maintain expertise in working within the assigned Electronic Health Record System(s) of the agency as well as city and state DOH resources; utilize the system daily and as needed to manage secure messages, charting needs, and all core functions of position. Support/coach team members as needed to enhance their capabilities in this area.
• Attend community meetings, committees, and trainings as requested; maintain and promote a positive image of the agency, department, and hub with the goal of fostering positive community relations to the benefit of the served members and agency mission at large.
• May attend outside meetings or conferences and or other duties as deemed necessary.

Minimum Qualifications

Minimum of 2 years’ experience in care coordination, care management, case work, with chronically ill, HIV/AIDS, homelessness, and substance abuse patients managing chronic health conditions and social needs. Or 5 years’ experience if the bachelor’s degree is not in one of the above listed concentrations.

1. Proficiency in Microsoft Office Suite (including but not limited to Word, Outlook, Excel)

2. Proficiency/experience working within electronic health record (EHR) systems.

3. Care Managers are based in Harlem office. Must travel between assigned work sites as needed.

4. Solid organizational and follow-up skills.

5. Computer Literacy learn and adapt to different IT platforms.

6. Excellent interpersonal skills.

7. Ability to manage and work with a variety of different people.

8. Flexibility to travel throughout the 5 Boroughs.

9. Maintain confidentiality / PHI/PII & HIPPA.

10. Capable of clear direct communication with others (oral and written).

11. Bilingual (English/Spanish/Arabic/Russian is a plus

Thank you for your interest in CABS Homecare! We look forward to receiving your submission!

E/O/E

Job Type: Full-time

Pay: $50,000.00 - $55,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Retirement plan

Schedule:

• Monday to Friday

Application Question(s):

• Familiarity with DOH, OMH, and HRA programs

Education:

• Bachelor's (Required)

Ability to Relocate:

• Brooklyn, NY 11206: Relocate before starting work (Required)

Willingness to travel:

• 50% (Required)

Work Location: In person