• Senior Manager, Care Management LTC

    Healthfirst (FL)


    Duties/Responsibilities:

    + Lead and manage the care management team to ensure the best individualized care decisions, adherence to timely assessments and interventions for each members changing condition(s)

    + Build a high performing team where clinical, technical and leadership skills are developed and assessed on a regular basis

    + Enforce guidelines as mandated by CMS and New York State regulations, job aides and HF policies. This includes review of performance audit reports in order to maintain superior and accurate care data for each member in the members electronic record.

    + Participate in the Quality Management Program, identifying performance/process improvement opportunities and recommend studies for annual quality plan.

    + Uses reports and data to foster care management

    + Assist with budget planning, preparation and adherence

    + Additional duties as assigned

    MinimumQualifications:

    + Associates degree from an accredited institution

    + NYS RN, LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state) or other relevant clinical license

    + Leadership experience in managing, coaching, and developing employees

    + Demonstrated ability to build and foster effective relationships

    + Working experience in a fast-paced environment overseeing multiple tasks while supporting a team

    + Proven track record of exercising independent thinking, problem solving and achieving quotas/goals

    Preferred Qualifications:

    + Bachelors degree

    + Experience working as a care manager for long term care programs such as MAP or MLTC

    + Knowledge of Medicare Regulations related to Long Term Care

    + Experience working and/or managing in a virtual environment

    + Problem-solving skills that can include emergency situations while communicating instructions and results in a succinct and clear verbal and written manner

    + Experience interacting with caregivers such as a family member to communicate instructions and explain sensitive issues at an expertise level that can be understood by the client

    + Experience in an environment using interdisciplinary / integrated model of care management sharing information among team members related to create an individualized comprehensive care plan

    + Understanding of health plans such as Medicare, Medicaid and/or Managed Long-Term Care Plan (MLTCP)

    + Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese

     

    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.