Care Manager

Care Manager

Job Ref: 132966
Category: Utilization Review and Case Management
Department: CASE MANAGEMENT
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Salary Range: $112,351.00 - $112,351.00

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's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Work Shifts

9:00 A.M – 5:00 P.M

Duties & Responsibilities

Address member’s problems and needs: clinical, psychosocial, financial, environmental

Provide services to members of varying age, risk level, clinical scenario, culture, financial means, social support, and motivation

Engage members in a collaborative relationship, empowering them to self-manage their physical, psychosocial, and environmental health to improve and maintain lifelong well being

Prepare member-oriented plan of care with member, caregivers, and health care providers, integrating concepts of cultural sensitivity and privacy practices

Participate in interdisciplinary rounds

Ensure plans of care have individualized goals and interventions

Communicate plan of care to Primary Care Physician

Address gaps in care with the member and provider

Address members social determinants of health issues

Link members to available resources

Provide care management support during Transitions of Care

Ensure member/caregiver understanding as it relates to language barriers, stress reaction or cognitive limitations/barriers

Train member on relevant chronic diseases, preventive care, medication management (medication reconciliation and adherence), home safety, etc.

Provide Complex care management including but not limited to; ensuring access to care, reducing unnecessary hospitalizations, and appropriately referring to community supports

Advocate for members by assisting them to address challenges and make informed choices regarding clinical status and treatment options

Employ critical thinking and judgment when dealing with unplanned issues

Maintain knowledge of Chronic Conditions and use job aids as a guidance

Maintain accurate, comprehensive, and current clinical and non-clinical documentation in DCMS, the Care Management System

Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies and procedures, and actively participate in evaluation process

Maintain professional competencies as a Care Manager

Other duties as assigned by Manager.

Minimum Qualifications

Qualification Requirements:
1. Valid New York State license and current registration to practice as a Registered Professional Nurse issued by the New York State Education Department (NYSED); and,
2. A Baccalaureate degree from an accredited college or university in Nursing or related health care field; and,
3. Two (2) years of experience as a Registered Professional Nurse.

Benefits

NYC Health and Hospitals offers a competitive benefits package that includes:

Comprehensive Health Benefits for employees hired to work 20+ hrs. per week

Retirement Savings and Pension Plans

Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts

Loan Forgiveness Programs for eligible employees

College tuition discounts and professional development opportunities

College Savings Program

Union Benefits for eligible titles

Multiple employee discounts programs

Commuter Benefits Programs