Address
Form of workiCircle is a licensed non-profit Managed Care Organization offering a health plan to individuals enrolled in Medicaid in 30 counties throughout the Western, Central, and Southern Tier regions of New York.
iCircle Values Its Employees by offering:
- Paid time off (including your Birthday!), Vacation time, Personal time and Sick Time
- Affordable health care coverage including health, dental, vision, starting as low as $10.00/month
- 403(B) Retirement plan
- Tuition Reimbursement
- Generous Employee referral program
- Numerous other benefits, please apply to find out more!
OVERVIEW:
Care Management is a collaborative process that includes assessing physical, social and environmental factors that affect the lives of iCircle Care members. The Care Manager implements an appropriate quality and cost-effective plan that utilizes all resources available to meet those needs. The Care manager utilizes evidence-based health strategies to prevent hospitalization and inappropriate utilization of emergency room visits. The process is cyclical in several phases: assessing, stratifying, planning, implementing/coordinating care and reassessing/evaluating. The Care Manager assists the member in reaching his/her optimum level of wellness, self-care management, and functional capabilities.
RESPONSIBILITIES:
- Oversee caseload of managed care members
- Review and evaluate the member's assessment and UAS information
- Develop comprehensive service plans
- Make referrals to appropriate health and community resources in timely manner
- Review and authorize request for services according to workflows and timeframes
- Maintain clear, effective communication with member continually, including monthly calls
- Educate members and caregivers on covered services and benefits
- Evaluate member in his/her residence on an as needed basis
- Promote healthy living and injury prevention for members
- Evaluate available clinical data and notes, including assessments
- Evaluate member's response to interventions and makes modifications as necessary
- Collaborate with interdisciplinary team
- Document all interventions
- Maintain member privacy, confidentiality, health, and safety
- Adhere to ethical, legal, accreditation, certification, and regulatory standards and guidelines
- Demonstrate cultural competence by being respectful of and responsive to the health beliefs, practices, cultural and language needs of the member and his/her support system
- Participate in Quality Assurance and Improvement activities
- On call responsibilities
- Performs all other duties as assigned by supervisor
ESSENTIAL ACADEMIC AND EXPERIENCE REQUIREMENTS:
- New York State Licensed Registered Nurse, Bachelor's degree preferred OR Licensed Master's Social Worker
- Minimum five years in healthcare related field, with 2 years as a care manager in managed care environment or community health
- Must be at least 18 years of age
- Reliable transportation (NYS Drivers' Licensed required)
- Ability to work independently and motivate others
- Ability to communicate effectively, both orally and in writing
- Maintain all required certifications/training by State regulations and iCircle policy
- Bilingual a plus
- High attention to detail
- Experience utilizing computer software including Microsoft Word and clinical applications
CDS Life Transitions is an Equal Opportunity Employer, and as such affirms the right of every person to participate in all aspects of employment without regard to gender, race, color, religion, national origin, ancestry, age, marital status, sexual orientation, pregnancy, disability, citizenship, military or veteran status, gender expression and/or identity, or any other status or characteristic protected by federal, state, or local law.
