Professional Case Manager

4 days ago


Schenectady, New York, United States MVP Health Care Full time
Job Summary

This position will utilize the essentials of an integrated Case Management model to meet the member's comprehensive health needs. Through collaborative efforts, the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner to provide appropriate education, resources, and healthcare coaching.

Key Responsibilities
  • Engage individual members and communicate with an established interdisciplinary team to create an individualized person-centered care plan.
  • Provide guidance in understanding benefit coverage and navigating the health care delivery system, including but not limited to Medicaid and Medicare benefits.
  • Monitor and review cases with the Medical Director to ensure appropriate outcomes.
  • Other duties as assigned by supervisor.
Requirements
  • Current New York State Licensure as a Registered Nurse is required.
  • Possession of Vermont licensure is preferred but can be obtained post-hire.
  • RN with multiple state licenses is preferred.
  • Bachelor's degree in nursing preferred.
  • Case Management Certification preferred (ANCC or CCM).
Preferred Qualifications
  • At least 3 years of recent clinical and Case Management experience.
  • Experience with Medicaid and Medicare programs and benefits strongly preferred.
  • Certification in Case Management required within 24 months after hire.
About MVP Health Care

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal.

We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location, relevant experience, education, and training, and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes paid time away from work, competitive 401(k) employer matching and profit-sharing program, low premium health benefits, life insurance and disability coverage, and an array of optional benefit plans.



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