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Healthcare Case Coordinator

2 months ago

Schenectady, New York, United States MVP Health Care Full time
Job OverviewProfessional, Case Manager

At MVP Health Care, we are a leading not-for-profit health insurer dedicated to enhancing the health and wellness of our members across New York and Vermont. Our diverse team of over 1,700 employees is committed to making health insurance more accessible and personalized.

Position Summary:

The Case Manager will employ a comprehensive Case Management framework that encompasses assessment, strategic planning, implementation, care coordination, ongoing monitoring, and advocacy to address the holistic health requirements of our members. This role involves collaborating with an interdisciplinary team to pinpoint the medical and psychosocial needs of assigned members, acting as a proactive resource to provide essential education, support, and healthcare coaching.

Key Responsibilities:
  • Engage with individual members to develop tailored, person-centered care plans.
  • Guide members in understanding their benefit coverage and navigating the healthcare system, including Medicaid and Medicare.
  • Identify and address barriers to care, facilitating optimal health outcomes and improved functional capabilities.
  • Monitor and review cases in conjunction with the Medical Director to ensure effective outcomes.
  • Perform additional duties as assigned by the supervisor.

Qualifications:
  • Active New York State Licensure as a Registered Nurse is mandatory.
  • Vermont licensure is preferred but can be obtained after hiring.
  • Possession of multiple state RN licenses is advantageous.
  • A Bachelor's degree in nursing is preferred.
  • Certification in Case Management (ANCC or CCM) is preferred.
Experience:
  • A minimum of 3 years of recent clinical and Case Management experience is required.
  • Experience with Medicaid and Medicare programs is highly desirable.
  • Certification in Case Management must be achieved within 24 months of employment.
Essential Skills:
  • Exceptional oral and written communication abilities.
  • Strong clinical knowledge with an understanding of population health management and the Case Management process.
  • Detail-oriented with excellent organizational skills and the ability to manage time effectively.
  • Capacity to thrive in a dynamic team environment.
  • Experience handling confidential information with discretion.
  • Proficient problem-solving skills, demonstrating clinical judgment and a realistic understanding of the healthcare landscape.
  • Ability to make independent decisions regarding care coordination and quality of care.
  • Strong judgment in emotionally charged situations, with an understanding of clinical and psychosocial issues that may influence treatment plans.
  • Proficient in computer skills, including familiarity with Windows and internet-based applications.

About MVP Health Care:

We are committed to providing competitive compensation and benefits packages to our employees. Our offerings include generous paid time off, competitive retirement plans, comprehensive health benefits, life insurance, and tuition reimbursement for continuous learning.

MVP Health Care is an Equal Employment Opportunity employer, dedicated to fostering a diverse and inclusive workplace. We welcome applicants from all backgrounds and are committed to providing accommodations for individuals with disabilities throughout the application process.