"Alerted.org

Duties and Responsibilities:

+ Provides telephonic (and occasional onsite) care management to support the members care needs to promote positive health outcomes.

+ Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.

+ Attends Interdisciplinary Team (IDT) Rounds several times per week to discuss and review high-risk cases

+ Conducts assessments to identify barriers and opportunities for intervention.

+ As needed, conduct home visits to high-risk members who need additional interventions.

+ Develops care plans that align with the physicians treatment plans and recommends interventions that align with proposed goals.

+ Generates referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement and maintenance of successful health outcomes.

+ Liaise between service providers such as doctors, nurse practitioners, social workers, discharge planners, and community-based service providers to ensure care is coordinated and care needs are adequately addressed.

+ Coordinates and facilitates with the multi-disciplinary health care team as necessary to ensure care plan goals and treatment is person-centered and maximizes member health outcomes.

+ Assists in identifying opportunities for alternative care options based on member needs and assessments.

+ Evaluates service authorizations to ensure alignment and execution of the members care and physician treatment plan.

+ Contributes to corporate goals through ongoing execution of member care plans and member goal achievement.

+ Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate.

+ Occasional overtime as necessary.

+ Additional duties as assigned.

Minimum Qualifications:

+ NYS RN, or

+ LCSW, LMSW, or licensed psychologist (any state)

+ Ability to travel around downstate New York which includes; the 5 boroughs, Long Island, and Westchester

Preferred Qualifications:

+ Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, along with demonstrated ability to handle rapidly changing situations.

+ Fluency in Spanish, Korean, Mandarin, or Cantonese.

+ Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors.

+ Experience managing member information in a shared network environment using paperless database modules and archival systems.

+ Experience and knowledge of the relevant product line

+ Relevant work experience preferably as a Care Manager

+ Demonstrated ability to manage member panels and work effectively in a fast-paced environment

+ Proficient with simultaneously navigating the Internet and multi-tasking with multiple electronic documentation systems

+ High level of competency usingMicrosoft Excel, Word and Powerpoint, including the ability to manage large data sets and reports

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.