Care Manager - New York, United States - Care Collab D.B.A Direct Care Management

Description

• Care Collab_ provides care coordination services to highutilization Medicaid members with chronic medical and behavioral health conditions. We're currently seeking a dynamic
  Care Manager to play a central role in the active engagement and coordination of care and services for our members and make referrals to address their behavioral, medical, and social needs.

The Care Manager has the responsibility for working as a lead member of the care team using principles of _assessment, care planning, service coordination, community referrals, and evaluation _to coordinate services using person-centered strategies for eligible participants.

The Care Manager is accountable for engaging and retaining Health Home enrollees in care; coordinating and arranging for the provision of services; supporting adherence to treatment recommendations; and monitoring and evaluating the member's needs, including prevention, wellness, medical, specialist and behavioral health treatment, care transitions, and social and community services where appropriate through the creation of an individual plan of care.

• Obtain required Care Management enrollment consent from the individual
• Complete initial and ongoing needs assessments to determine the individuals most appropriate level of care management
• Develop a plan of care and crisis plan with each member
• And accurately document the services provided on time.
• Responsible for the overall management of the member's Individualized Plan of Care.
• Meet Care Management documentation requirements in a timely and accurate manner by effectively utilizing designated Care Management Portal and Electronic Health Records (EHRs)
• Function as an advocate for members within the agency and external service providers
• Promote wellness and prevention by linking enrollees with resources and services based on their individual needs and preferences
• Educate the caregiver on the care of chronic conditions, screening and other preventive interventions
• Help members to obtain and maintain public benefits necessary to gain health care services, including Medicaid and cash assistance eligibility, Social Security, SNAP, housing, legal services, employment and training supports, and others
• Effectively communicate and share information with the individual and their families and other caregivers with appropriate consideration for language, literacy, and cultural preferences
• Conduct care planning meetings/conferences and serve as an interdisciplinary team member to effectively provide/coordinate comprehensive and holistic care
• Identify available communitybased resources and actively manage appropriate referrals, access, engagement, followup and coordination of services
• In the event of hospital admissions, actively engage in the discharge planning process ensuring that the member has all recommended postdischarge services in place prior to discharge
• Attend and participate in ongoing staff development training to enhance skills needed to effectively meet the demands of the Care Manager position
• Provide all interventions and care coordination in the individual's home and in the community
• Work with external stakeholdersincluding hospitals, shelters, jails, probation and parole officers, primary care providers, achieve positive client outcomes

• Bachelor's
  OR associate's degree in a related field
  OR 2+ years of jobrelated experience providing medical, mental health, or substancefocused services to individuals with chronic medical conditions and/or serious behavioral health conditions.
• Excellent interpersonal skills with ability to interact culturally, linguistically, and diplomatically with diverse internal and external audiences.
• Strong organizational skills to manage multiple priorities in a timesensitive manner.
• Ability to engage individuals and diffuse difficult situations.
• Health Home experience or equivalent programs preferred.
• Experience in a multidisciplinary setting and fieldbased clinical work preferred
• Excellent written and verbal communication skills.

• Work is both inoffice and in the Field
• COVID19 vaccination is
  not required at this time.
• Should be able to work with mínimal supervision.
• Light physical effort (lift/carry up to 15 pounds)
• Ability to commute to and from the Brooklyn office via driving, ridesharing or public transportation.
• Public Transportation to and from field visits is covered by the employer.

• Health insurance
• Paid time off
• Referral program

• 8 hour shift
• Day