Healthcare Advocate

3 weeks ago


New York, New York, United States MetroPlusHealth Full time

Job Overview

The Care Manager is responsible for optimizing members' healthcare experiences, resulting in cost savings due to improved quality of care. This involves engaging with members to understand their needs, environment, and available services.

Key Responsibilities:

  • Assess and evaluate members' needs, providing creative solutions to address challenges.
  • Serve as a member advocate, accompanying them throughout their care journey.
  • Monitor and assess the value added to improving members' health status, including disease management, physical and behavioral well-being, medication adherence, and emergency service utilization.
  • Support members in need, problem-solving issues beneficially for the member and Plan.

Requirements

  • Master's Degree required.
  • Minimum 3 years' experience in case management in a healthcare and/or managed care setting.
  • Proficiency with computers navigating multiple systems and web-based applications.
  • Ability to read and interpret medical records, claims data, pharmacy, and lab reports.
  • LMSW/LCSW with current NYS license.

Salary: $65,000 - $85,000 per year


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