- Performs care management including hospital admission certification, continued stay review, discharge planning, outpatient, and ancillary services review, etc., following established MetroPlusHealth
- Utilization Management policies, procedures, and protocols.
- Oversee the coordination and delivery of comprehensive, quality healthcare and services for all members requiring care management in a cost-effective manner.
- Interacts and obtains relevant clinical information from members' PCP and other providers; approves care that meets established criteria; and refers all other cases to the MetroPlusHealth Physician
- Advisor/Medical Director. Informs member and provider of Utilization Management determinations and treatment alternatives.
- Identifies utilization trends and potential member needs by means of generating reports of encounter data,
- pharmacy data review, and new member health assessment forms.
- Evaluate member needs for referred cases (from providers or member self-referred).
- Assists all departments with the resolution of members' problems related to utilization management issues.
- Performs all Utilization Management activities in compliance with all regulatory agency requirements.
- Conducts medical record reviews as appropriate to case management functions.
- Participate in Medical Management grand rounds with the Physician Advisor.
- Performs all other duties as assign
- High School Diploma General Equivalency Diploma (GED) required; and
- 2-5 years' clinical experience in an acute or applicable care setting.
- UM/UR experience in managed care or hospital setting required.
- New York State license as Registered Nurse, License Practical Nurse, or Physical Therapist required
- Integrity and Trust
- Customer Focus
- Excellent communication, written and analytical skills
- Knowledge of computer systems
-
Part Time
Found in: Lensa US 4 C2 - 4 days ago
Lowe's Brooklyn, United States Part time**Essential Functions:** · **NOTE:** Minors in this role may not be responsible for some of the activities listed below · Assisted Self Check Out · • Demonstrates ability to monitor and identify customers who need assistance at multiple self-checkout registers simultaneously · • ...
-
Part Time
Found in: One Red Cent US C2 - 5 days ago
Lowe's Brooklyn, United States Part timeEssential Functions: · NOTE: Minors in this role may not be responsible for some of the activities listed below · Assisted Self Check Out · * Demonstrates ability to monitor and identify customers who need assistance at multiple self-checkout registers simultaneously · * Appr ...
-
Part Time
Found in: Lensa US 4 C2 - 1 day ago
Lowe's Brooklyn, United States Part timeLowe's nd Avenue [Department Manager] As a Head Cashier at Lowe's, you'll: Provide supervision, coaching, and support to the Customer Service Associate - Front End Team; Help open or close the front-end of the store; Deliver a checkout experience that is quick, professional, and ...
-
Cleaning part-time job in Heidelberg
Found in: Orion Innovations US - 6 days ago
Diamond Dynamics East York, PA, United States Freelance**Crystal Service** is a professional and competent cleaning and hygiene company founded in 2005 in East York, PA. Our top priority is ensuring our customers are always satisfied, and we have been successful in achieving this goal. We also strive to provide a pleasant and harmoni ...
-
Part-Time Sales Associate
5 days ago
Brooks Brothers Verified Company New York City, United States Full time $30,000 - $80,000 per yearResponsibilities · As a Sales Associate you will: · Engage and connect with customers to create an amazing shopping experience. · Achieve and exceed sales goals by executing our selling strategy. · Share product knowledge with customers to maximize sales. · Engage with customers ...
-
psychiatrist - part time
Found in: MyJobHelper US C2 - 3 days ago
Adapt Community Network Brooklyn Heights, NY , USA, United States Part timeWhy Join ADAPT? · It's more than a job; it's a calling. It's where passion meets purpose. ADAPT Community Network, formerly United Cerebral Palsy (UCP) of NYC provides a multitude of services to people with developmental disabilities. At ADAPT, we are 3,000 strong, and it takes e ...
-
Part Time Receptionist
Found in: Lensa US 4 C2 - 5 days ago
Bay Ridge Honda Brooklyn, United States Part timeWe are looking for a part time receptionist who enjoys working with the public and has a friendly, outgoing personality. As a team-oriented company, we seek an individual who can be flexible with work hours. The ideal candidate is dedicated to providing exceptional customer servi ...
-
Pedagogical specialist in full-time or part-time
Found in: Orion Innovations US - 6 days ago
Apex Ventures Hudson, NY, United States FreelanceThe Evangelical Nature Kindergarten Pusteblume in Hudson, NY is open from 8:00 am to 2:00 pm. The kindergarten is run by the Diakonissenmutterhaus Aidlingen. · Located on the spacious grounds of the Diakonissenmutterhaus, the group of 25 children aged 2 to 6 has two child-friendl ...
-
Part Time Physician
Found in: Jooble US O L C2 - 3 days ago
Greenlife Healthcare Staffing Brooklyn, NY, United States Part timeAre you a BC or BE Psychiatrist, with at least a year of clinical experience, familiar with EMR, and with strong writing & communication skills? Would you enjoy working part-time in a new division of a multi-specialty clinic, in a relatively undiscovered part of Brooklyn? You wou ...
-
Cashier Part Time
Found in: Lensa US 4 C2 - 1 day ago
Lowe's Brooklyn, United States Part timeLowe's nd Avenue [Retail Cashier / Team Member] As a Cashier at Lowe's, you'll: Deliver a checkout experience that is quick, professional, and friendly; Ensure merchandise is accurately accounted, scanned, and meets the needs of customers; Engage in safe work practices and encour ...
-
BARISTA (FULL TIME and PART TIME)
Found in: MyJobHelper US C2 - 1 day ago
Compass Brooklyn, United StatesMakes and serves coffee/espresso drinks and related food and beverage items. Handles food according to HACCP guidelines and standards for quality food-service operations. Interacts with customers and other employees in a friendly, courteous manner. E Barista, Part Time, Restauran ...
-
Part-Time Ambassador
Found in: Talent US C2 - 8 hours ago
Everlane Brooklyn, United States Part timeAt Everlane, we want the right choice to be as easy as putting on a great T-shirt. That's why we partner with ethical factories around the world. Work with high quality and more sustainably sourced materials. And share the true cost of every product we make. But there's a lot mor ...
-
Part-time job
Found in: Orion Innovations US - 6 days ago
Titan Industries Plainedge, NY, United States FreelanceOur colleagues at the branch in Bremen, Hans-Bredow-Straße 19, Weserpark, are looking forward to your support as a part-time employee (m/f/d). · We love shoes and accessories of the highest quality - and we have been doing so since 1875 From a small branch in Hamburg-Barmbek, we ...
-
Temporary employee for stocking shelves part-time job
Found in: Orion Innovations US - 6 days ago
Skyline Solutions New City, NY, United States FreelanceNew City, NY Branch · 1 Eisenbahnstr. · 76646 Bruchsal · We believe our customers deserve only the best, and that includes you. You fulfill customer requests effortlessly and as a true sales talent, you always keep an overview. We are glad you are here and we show our appreciatio ...
-
Part Time Merchandiser
Found in: beBee S2 US - 5 days ago
American Greetings Brooklyn, United States Part timeAmerican Greetings is a global leader in the Celebrations marketplace. · Celebrate with us and join our team today · As a Merchandiser with American Greetings, you are a vital part of our company's purpose: helping people celebrate holidays, each other, and all of life's special ...
-
Doctor (Full Time / Part-Time)
Found in: Jooble US O L C2 - 3 days ago
StaffPhysicians Brooklyn, NY, United States Part timeA group in NYC is looking for a GYN physician to join their established practice. They are looking for full time or part time. Office-only procedures or minor and major surgeries. A sign-on bonus can be negotiated upon. They are offering full medical benefits, CME time as well as ...
-
Part-Time Merchandiser
Found in: beBee S2 US - 1 week ago
Union Beer Distributors Brooklyn, United States Part timeAt Union Beer Distributing, we believe in doing right by our employees, suppliers, customers, and communities. We believe hard work delivers results. And we believe these values are why our network of distributors, the Sheehan Family Companies, has been in business for over 125 y ...
-
Part time nanny
Found in: beBee S2 US - 3 days ago
Sittercity Brooklyn, United States Part timeDrew is a social, imaginative 3 year old who loves dragons and dinosaurs - he has vivid imaginative play and is interested in figuring out how things work. · Maya is an easygoing baby with an infectious smile. She loves to explore and of course tries to keep up with her older br ...
-
Part-time Human Resources Clerk
Found in: Orion Innovations US - 6 days ago
Neptune Enterprises Hall, NY, United States FreelanceAre you an experienced HR professional who knows exactly what you're capable of? Then this is your new professional challenge. We will support you on your way to your dream employer - quickly, competently, and at no cost to you. · **Advantages that will bring you to your dream jo ...
-
Cashier (Full-Time/Part-Time)
Found in: Lensa US 4 C2 - 1 day ago
KWIK FILL Brooklyn, United StatesKwik Fill - 346 W. Morris St. [Retail Cashier / Team Member] As a Cashier at Kwik Fill, you'll: Operate the cash register accurately, and account for all shift transactions accurately; Perform customer service/suggestive selling; Be responsible for the accurate operation of regis ...
Care Manager Part Time - New York, United States - MetroPlus Health Plan
Description
Care Manager Part Time
Job Ref: 105903
Category: Utilization Review and Case Management
Department: UTILIZATION MANAGEMENT
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Part-Time
Salary Range: $41, $41,435.00
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
The Care Manager, under the direction of the Vice President of Clinical Services, is primarily responsible for
managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize
unnecessary medical expenses, through the coordination of services, both outpatient and inpatient. The Care
Manager will assist the provider in directing care to the most appropriate setting, evaluating alternative care plans, and assessing outcomes through outreach to the members.
Job Description
Minimum Qualifications
Licensure and/or Certification Required:
Professional Competencies: